Active NPI
Kennon Garcia
- Behavior Technician
- Fresno, CA
National Provider Identifier
1205304318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1630 E Shaw Ave Ste 190
Fresno, CA 93710-8114 - Phone
- (559) 475-7860
- Fax
- (559) 570-0222
- NPI assigned
- Nov 6, 2018
- Last updated
- Nov 6, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1630 E Shaw Ave Ste 190
Fresno, CA 93710-8114
Mailing address
5132 N Palm Ave
PMB 303
Fresno, CA 93704
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": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1205304318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5132 N PALM AVE",
"address_2": "PMB 303",
"city": "FRESNO",
"state": "CA",
"postal_code": "93704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 E SHAW AVE STE 190",
"city": "FRESNO",
"state": "CA",
"postal_code": "937108114",
"telephone_number": "559-475-7860",
"fax_number": "559-570-0222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "KENNON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-06",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.