Individual provider Active NPI

Jenna French, BCBA

  • Behavior Analyst
  • Bloomington, MN
National Provider Identifier
1235536863
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-10092
Practice address
9001 E Bloomington Fwy
Suite 143
Bloomington, MN 55420-3435
Phone
(952) 777-4996
Fax
(952) 777-2004
NPI assigned
Nov 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-10092 Primary

Addresses

Primary practice location

9001 E Bloomington Fwy
Suite 143
Bloomington, MN 55420-3435

Mailing address

2230 Ranchview LN N
#95
Plymouth, MN 55447-6468
Phone (757) 274-3331

Other identifiers 1

IdentifierTypeStateIssuer
1-14-10092OtherBCBA CERTIFICATE

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": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1235536863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 RANCHVIEW LN N",
            "address_2": "#95",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554476468",
            "telephone_number": "757-274-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 E BLOOMINGTON FWY",
            "address_2": "SUITE 143",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203435",
            "telephone_number": "952-777-4996",
            "fax_number": "952-777-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRENCH",
        "first_name": "JENNA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-14-10092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-14-10092",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.