Active NPI
Shawuana Smith
- Behavior Technician
- Marina, CA
National Provider Identifier
1215672134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 721 Bandholtz CT
Marina, CA 93933-4713 - Phone
- (408) 688-1373
- NPI assigned
- May 4, 2022
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
721 Bandholtz CT
Marina, CA 93933-4713
Mailing address
721 Bandholtz CT
Marina, CA 93933-4713
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPR478M79657 | Other | CA | ATHEM BLUE CROSS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | shawuanalee7050@outlook.com | Direct | Central Coast ABA LLC |
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": "1651622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1215672134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 BANDHOLTZ CT",
"city": "MARINA",
"state": "CA",
"postal_code": "939334713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 BANDHOLTZ CT",
"city": "MARINA",
"state": "CA",
"postal_code": "939334713",
"telephone_number": "408-688-1373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SHAWUANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-04",
"last_updated": "2022-05-04",
"certification_date": "2022-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHEM BLUE CROSS",
"identifier": "CPR478M79657",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "shawuanalee7050@outlook.com",
"affiliation": "Y",
"affiliationName": "Central Coast ABA LLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "Central Coast ABA",
"city": "salinas",
"state": "CA",
"country_code": "US",
"postal_code": "93901",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.