Summer Djenae Mitchell

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

75 Park Creek Dr Ste 104
Clovis, CA 93611-4432

Phone

(559) 878-1389

NPI assigned

Mar 12, 2020

Last updated

Mar 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1194350900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2667 ASHLAN AVE APT 220",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936113977",
            "telephone_number": "559-878-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PARK CREEK DR STE 104",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114432",
            "telephone_number": "559-878-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SUMMER",
        "middle_name": "DJENAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DRIVERS LICENSE",
            "identifier": "D6861642",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sm7229@centerforautism.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Personal email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "75 Park Creek Dr Ste 104",
            "city": "Clovis",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936114432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Lee Minton, MD
• Judy Miramontes, M.D.
• Lovik Mirzaeian, D.D.S.
• Mitchell Imaging Mobile Diagnostic Ultrasound, LLC
• Kale'a Lani Rose Mitchell
• Jocelyn Ann Mizunaka, MD
• Simon Farid Mizyed, PA-C
• Mobilexpress LLC (MobileXpress)
• Evelyn Moctezuma - Cruz
• Modern Axiro LLC

• Behavior Technician in Clovis, CA
• Providers in Clovis, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.