Active NPI
Mira Periasamy
- Behavior Technician
- Fairfield, CA
National Provider Identifier
1225817281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 796 Dogwood Cir
Fairfield, CA 94533-1457 - Phone
- (707) 344-5826
- NPI assigned
- Sep 27, 2023
- 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
796 Dogwood Cir
Fairfield, CA 94533-1457
Mailing address
616 Butcher Rd
Vacaville, CA 95687
Phone (707) 908-9800
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": "1695772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1225817281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 BUTCHER RD",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95687",
"telephone_number": "707-908-9800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "796 DOGWOOD CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331457",
"telephone_number": "707-344-5826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERIASAMY",
"first_name": "MIRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-27",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.