Individual provider Active NPI

Maxwell Augustson

  • Behavior Technician
  • Simi Valley, CA
National Provider Identifier
1184199044
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1900 E Los Angeles Ave Ste 100
Simi Valley, CA 93065-6560
Phone
(805) 537-0620
NPI assigned
Oct 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

1900 E Los Angeles Ave Ste 100
Simi Valley, CA 93065-6560

Mailing address

2625 Townsgate Rd Ste 1102
Westlake Village, CA 91361-5751
Phone (805) 413-3009

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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1184199044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 TOWNSGATE RD STE 1102",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913615751",
            "telephone_number": "805-413-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E LOS ANGELES AVE STE 100",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656560",
            "telephone_number": "805-537-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTSON",
        "first_name": "MAXWELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.