Individual provider Active NPI

Samantha Nicole Romero

  • Behavior Analyst
  • Orange, CA
National Provider Identifier
1245795616
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12153309 Issued in CA
Practice address
1820 W Orangewood Ave Ste 110
Orange, CA 92868-5056
Phone
(714) 786-6069
Fax
(714) 242-9308
NPI assigned
Feb 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 12153309 CA Primary

Addresses

Primary practice location

1820 W Orangewood Ave Ste 110
Orange, CA 92868-5056

Mailing address

1820 W Orangewood Ave Ste 110
Orange, CA 92868-5056
Phone (714) 786-6069

Other practice location 1

3303 Harbor Blvd Ste B8
Costa Mesa, CA 92626-1517
Phone (714) 834-6069

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

State licenses

LicenseStateTypeSpecialty
12153309CAMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1245795616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 W ORANGEWOOD AVE STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685056",
            "telephone_number": "714-786-6069",
            "fax_number": "714-242-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 W ORANGEWOOD AVE STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685056",
            "telephone_number": "714-786-6069",
            "fax_number": "714-242-9308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 Harbor Blvd Ste B8",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926261517",
            "country_code": "US",
            "telephone_number": "714-834-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "SAMANTHA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-09",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "12153309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.