Active NPI
Jason Tan
- Behavior Technician
- San Bruno, CA
National Provider Identifier
1215528468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 901 Sneath LN Ste 105
San Bruno, CA 94066-2415 - Phone
- (855) 223-7123
- NPI assigned
- Jan 31, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
901 Sneath LN Ste 105
San Bruno, CA 94066-2415
Mailing address
6621 Geary Blvd 2ND Floor
San Francisco, CA 94121
Phone (415) 386-6600
Other practice location 1
6621 Geary Blvd 2nd Floor
San Francisco, CA 94121
Phone (415) 386-6600
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": "1612051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1215528468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6621 GEARY BLVD 2ND FLOOR",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94121",
"telephone_number": "415-386-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 SNEATH LN STE 105",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940662415",
"telephone_number": "855-223-7123"
}
],
"practiceLocations": [
{
"address_1": "6621 Geary Blvd 2nd Floor",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "94121",
"country_code": "US",
"telephone_number": "415-386-6600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAN",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-31",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.