Breana Monique Betancourt

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

Y2699305 Issued in CA

Practice address

1300 W Gonzales Rd Ste 201
Oxnard, CA 93036-3355

Phone

(714) 202-0118

NPI assigned

Aug 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1596240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596240000000",
    "number": "1245840669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 LANTANA ST APT 26",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106134",
            "telephone_number": "805-298-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W GONZALES RD STE 201",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930363355",
            "telephone_number": "714-202-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "BREANA",
        "middle_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-01",
        "last_updated": "2020-08-01",
        "certification_date": "2020-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "Y2699305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbetancourt@active-step.com",
            "affiliation": "N",
            "address_1": "1300 W Gonzales Rd Ste 201",
            "city": "Oxnard",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930363355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Raj Bhatia, MD
• Zoe Jade Bias

• Behavior Technician in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2020; 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.