Individual provider Active NPI

Jose Rodolfo Magdaleno

  • Behavior Technician
  • Martinez, CA
National Provider Identifier
1235706102
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1330 Arnold Dr Ste 148
Martinez, CA 94553-6538
Phone
(925) 310-6311
NPI assigned
Jun 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1330 Arnold Dr Ste 148
Martinez, CA 94553-6538

Mailing address

1153 Rumrill Blvd TRLR 51
San Pablo, CA 94806-4631
Phone (510) 621-4362

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1235706102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 RUMRILL BLVD TRLR 51",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948064631",
            "telephone_number": "510-621-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ARNOLD DR STE 148",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945536538",
            "telephone_number": "925-310-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDALENO",
        "first_name": "JOSE",
        "middle_name": "RODOLFO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.