Active NPI
Austin Stotelmyre
- Behavior Technician
- Costa Mesa, CA
National Provider Identifier
1265071096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1111 Baker St Costa Mesa 92626
Costa Mesa, CA 92626 - Phone
- (818) 241-6780
- NPI assigned
- Dec 26, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CA | Primary |
Addresses
Primary practice location
1111 Baker St Costa Mesa 92626
Costa Mesa, CA 92626
Mailing address
1055 E Colorado Blvd Ste 560
Pasadena, CA 91106-2380
Phone (818) 241-6780
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1265071096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 E COLORADO BLVD STE 560",
"city": "PASADENA",
"state": "CA",
"postal_code": "911062380",
"telephone_number": "818-241-6780",
"fax_number": "818-241-6853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 BAKER ST COSTA MESA 92626",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "818-241-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOTELMYRE",
"first_name": "AUSTIN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-26",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.