Individual provider Active NPI

Mimi Tran

  • Behavior Technician
  • San Jose, CA
National Provider Identifier
1205462959
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1835 Park Ave
San Jose, CA 95126-1629
Phone
(303) 989-8169
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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 CA Primary

Addresses

Primary practice location

1835 Park Ave
San Jose, CA 95126-1629

Mailing address

631 River Oaks Pkwy
San Jose, CA 95134-1907

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1205462959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 RIVER OAKS PKWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 PARK AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261629",
            "telephone_number": "303-989-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2025; 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.