Individual provider Active NPI

Kristina Neu

  • Behavior Technician
  • Tustin, CA
National Provider Identifier
1174346340
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
290 S Prospect Ave Ste a
Tustin, CA 92780-1523
Phone
(415) 646-6223
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

290 S Prospect Ave Ste a
Tustin, CA 92780-1523

Mailing address

4001 Mesa Rd # A512
Irvine, CA 92617-5003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1174346340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 MESA RD # A512",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926175003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S PROSPECT AVE STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801523",
            "telephone_number": "415-646-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEU",
        "first_name": "KRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.