Active NPI
Ruth Candelario
- Behavior Analyst
- Fullerton, CA
National Provider Identifier
1194289793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-57198
- Practice address
- 713 W Commonwealth Ave Ste C
Fullerton, CA 92832-1612 - Phone
- (714) 879-4274
- NPI assigned
- Jan 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-57198 | CA | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
713 W Commonwealth Ave Ste C
Fullerton, CA 92832-1612
Mailing address
32565 Golden Lantern Ste B180
Dana Point, CA 92629
Other practice location 1
32565 Golden Lantern Suite B #180
Dana Point, CA 92629
Phone (714) 552-1317
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": "1548633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1194289793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32565 GOLDEN LANTERN STE B180",
"city": "DANA POINT",
"state": "CA",
"postal_code": "92629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 W COMMONWEALTH AVE STE C",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321612",
"telephone_number": "714-879-4274"
}
],
"practiceLocations": [
{
"address_1": "32565 Golden Lantern Suite B #180",
"address_purpose": "LOCATION",
"city": "Dana Point",
"state": "CA",
"postal_code": "92629",
"country_code": "US",
"telephone_number": "714-552-1317",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANDELARIO",
"first_name": "RUTH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-28",
"last_updated": "2021-12-23",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-21-57198",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.