Active NPI
Susan Avila
- Behavior Technician
- Yuma, AZ
National Provider Identifier
1306166103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 791 S 4TH Ave
Yuma, AZ 85364-3067 - Phone
- (928) 920-6220
- NPI assigned
- Jun 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
791 S 4TH Ave
Yuma, AZ 85364-3067
Mailing address
799 W 10TH St
Yuma, AZ 85364-3750
Phone (928) 450-0554
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": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729987200000",
"number": "1306166103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "799 W 10TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853643750",
"telephone_number": "928-450-0554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "791 S 4TH AVE",
"city": "YUMA",
"state": "AZ",
"postal_code": "853643067",
"telephone_number": "928-920-6220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-03",
"last_updated": "2024-10-27",
"certification_date": "2024-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"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 Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.