Individual provider Active NPI

Edwin Alvaro Centeno

  • Behavior Technician
  • Monrovia, CA
National Provider Identifier
1225516057
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406
Phone
(626) 775-7888
NPI assigned
Aug 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X CA Primary

Addresses

Primary practice location

612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406

Mailing address

5291 Wenatchee Way
Riverside, CA 92509-7821
Phone (951) 398-2970

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1225516057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5291 WENATCHEE WAY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925097821",
            "telephone_number": "951-398-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S MYRTLE AVE STE 100",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163406",
            "telephone_number": "626-775-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTENO",
        "first_name": "EDWIN",
        "middle_name": "ALVARO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.