Active NPI
Prinston Abel Fontenberry, ASSOCIATES
- Behavior Technician
- Lathrop, CA
National Provider Identifier
1215744107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 13382 Pipestone St
Lathrop, CA 95330-8825 - Phone
- (209) 752-0079
- NPI assigned
- Dec 13, 2024
- 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
13382 Pipestone St
Lathrop, CA 95330-8825
Mailing address
13382 Pipestone St
Lathrop, CA 95330-8825
Phone (209) 752-0079
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": "1734048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1215744107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13382 PIPESTONE ST",
"city": "LATHROP",
"state": "CA",
"postal_code": "953308825",
"telephone_number": "209-752-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13382 PIPESTONE ST",
"city": "LATHROP",
"state": "CA",
"postal_code": "953308825",
"telephone_number": "209-752-0079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENBERRY",
"first_name": "PRINSTON",
"middle_name": "ABEL",
"credential": "ASSOCIATES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-13",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lathrop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.