Henry Mark Bandettini

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

6400 Tupelo Dr
Citrus Heights, CA 95621-1741

Phone

(916) 729-3098

NPI assigned

Sep 21, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1194503979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 OAK AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163629",
            "telephone_number": "949-289-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 TUPELO DR",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211741",
            "telephone_number": "916-729-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDETTINI",
        "first_name": "HENRY",
        "middle_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danieltroy Frank Balderas
• Brianna Baldwin
• Allissa Bales
• Kristin Claire Ball, AMFT
• Darya Bandalak
• Destiny Devin Baptista-Alcaide
• Vanessa Michelle Barahona
• Miguel Angel Barajas-McGahan
• Sean Lorenzo Baratas Ganados
• Cheyanne Barba, PHD

• All providers in Citrus Heights, CA
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.