Kathryn Trask

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

18-59555 Issued in CA

Practice address

1670 Corporate Cir Ste 100
Petaluma, CA 94954

Phone

(707) 308-2120

NPI assigned

Sep 28, 2018

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

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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1295210938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 CORPORATE CIR STE 100",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CORPORATE CIR STE 100",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-308-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Mill St",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954045036",
            "country_code": "US",
            "telephone_number": "925-822-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 Mill St",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954045036",
            "country_code": "US",
            "telephone_number": "925-822-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2730 Shadelands Dr Bldg 10",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945982538",
            "country_code": "US",
            "telephone_number": "707-308-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRASK",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "18-59555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Matthew Kent Tribble
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• Behavior Technician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.