Latasha Fae Faraudo

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

191464023 Issued in UT

Practice address

6910 S Highland Dr
Cottonwood Heights, UT 84121-3060

Phone

(800) 434-8923

NPI assigned

Mar 9, 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

Other names 1

• Latasha Fae Makin Other name

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1255966388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3396 W 350 N",
            "city": "WEST POINT",
            "state": "UT",
            "postal_code": "840157447",
            "telephone_number": "801-643-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 S HIGHLAND DR",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841213060",
            "telephone_number": "800-434-8923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3396 W 350 N",
            "address_purpose": "LOCATION",
            "city": "West Point",
            "state": "UT",
            "postal_code": "840157447",
            "country_code": "US",
            "telephone_number": "801-643-6862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAUDO",
        "first_name": "LATASHA",
        "middle_name": "FAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "UT",
            "license": "191464023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATASHA",
            "last_name": "MAKIN",
            "middle_name": "FAE",
            "credential": "TASHA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tristin Endicott, PA-C
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• Sophia Fagone
• Falck Therapy
• Benjamin Feinauer
• Megan Ferguson
• Melissa Lynn Ferguson, LPC
• Maren Vanwagoner Ferre, FNP-BC
• Audrey Ferry

• Behavior Technician in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Behavior Technician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.