Individual provider Active NPI

Lisette Julia Randich, M.A., BCBA

  • Behavior Analyst
  • Kirkland, WA
National Provider Identifier
1184862476
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
9046 NE 141St St
Kirkland, WA 98034-5118
Phone
(303) 859-4838
NPI assigned
Jan 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

9046 NE 141St St
Kirkland, WA 98034-5118

Mailing address

9046 NE 141St St
Kirkland, WA 98034-5118
Phone (303) 859-4838

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1184862476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9046 NE 141ST ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345118",
            "telephone_number": "303-859-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9046 NE 141ST ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345118",
            "telephone_number": "303-859-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDICH",
        "first_name": "LISETTE",
        "middle_name": "JULIA",
        "credential": "M.A., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.