Active NPI
Angie Habroun
- Behavior Technician
- Ontario, CA
National Provider Identifier
1255190435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4688 Ontario Mills Pkwy
Ontario, CA 91764-5104 - Phone
- (909) 476-5747
- NPI assigned
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
4688 Ontario Mills Pkwy
Ontario, CA 91764-5104
Mailing address
504 N Placer Privado
Ontario, CA 91764-5660
Phone (909) 723-4106
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Genius LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1255190435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 N PLACER PRIVADO",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917645660",
"telephone_number": "909-723-4106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4688 ONTARIO MILLS PKWY",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917645104",
"telephone_number": "909-476-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABROUN",
"first_name": "ANGIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.