Individual provider Active NPI

Michelle Leah Alonzo Evans

  • Behavior Technician
  • Chula Vista, CA
National Provider Identifier
1255039673
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
00018269 Issued in CA
Practice address
891 Kuhn Dr Ste 110
Chula Vista, CA 91914-3551
Phone
(619) 864-7070
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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 00018269 CA Primary

Addresses

Primary practice location

891 Kuhn Dr Ste 110
Chula Vista, CA 91914-3551

Mailing address

5850 Granite Pkwy Ste 600
Plano, TX 75024-6753

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
00018269CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1255039673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 GRANITE PKWY STE 600",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 KUHN DR STE 110",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143551",
            "telephone_number": "619-864-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MICHELLE",
        "middle_name": "LEAH ALONZO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "00018269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.