Individual provider Active NPI

Astrid Vanessa Palencia Vallar

  • Behavior Technician
  • Oakland, CA
National Provider Identifier
1194662015
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
Y9020774 Issued in CA
Practice address
2580 Fruitvale Ave Apt B
Oakland, CA 94601-1964
Phone
(510) 282-6836
NPI assigned
Apr 29, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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 Y9020774 CA Primary

Addresses

Primary practice location

2580 Fruitvale Ave Apt B
Oakland, CA 94601-1964

Mailing address

1075 Creekside Ridge Dr Ste 280
Roseville, CA 95678-3504
Phone (510) 282-6836

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

State licenses

LicenseStateTypeSpecialty
Y9020774CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1194662015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 CREEKSIDE RIDGE DR STE 280",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956783504",
            "telephone_number": "510-282-6836",
            "fax_number": "510-282-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 FRUITVALE AVE APT B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011964",
            "telephone_number": "510-282-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALENCIA VALLAR",
        "first_name": "ASTRID",
        "middle_name": "VANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "Y9020774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.