Active NPI
Jennifer R Vannarath
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1215571724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BEH-000852
- Practice address
- 3201 W Peoria Ave
Phoenix, AZ 85029-4608 - Phone
- (602) 926-7200
- Fax
- (602) 368-2730
- NPI assigned
- Oct 29, 2019
- Sex
- Female
- 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 Analyst | 103K00000X | BEH-000852 | AZ | Primary |
Addresses
Primary practice location
3201 W Peoria Ave
Phoenix, AZ 85029-4608
Mailing address
4001 W Lawrence LN
Phoenix, AZ 85051-3661
Phone (602) 525-7384
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
| License | State | Type | Specialty |
|---|---|---|---|
| BEH-000852 | AZ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1215571724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 W LAWRENCE LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850513661",
"telephone_number": "602-525-7384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 W PEORIA AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850294608",
"telephone_number": "602-926-7200",
"fax_number": "602-368-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANNARATH",
"first_name": "JENNIFER",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-29",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "BEH-000852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.