Individual provider Active NPI

Randall Lawrence Simonin

  • Behavior Technician
  • Sunnyvale, CA
National Provider Identifier
1245039379
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1629 Waxwing Ave
Sunnyvale, CA 94087-5154
Phone
(408) 338-7239
Fax
(408) 338-7239
NPI assigned
Mar 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

1629 Waxwing Ave
Sunnyvale, CA 94087-5154

Mailing address

1629 Waxwing Ave
Sunnyvale, CA 94087-5154
Phone (408) 338-7239

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": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1245039379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 WAXWING AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940875154",
            "telephone_number": "408-338-7239",
            "fax_number": "408-338-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 WAXWING AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940875154",
            "telephone_number": "408-338-7239",
            "fax_number": "408-338-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONIN",
        "first_name": "RANDALL",
        "middle_name": "LAWRENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.