Active NPI
Deseray Joycelin R Juarez
- Behavior Technician
- Roseville, CA
National Provider Identifier
1306476734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 123 Main St
Roseville, CA 95678 - Phone
- (916) 410-2449
- NPI assigned
- Jan 24, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
123 Main St
Roseville, CA 95678
Mailing address
6351 Westholme Way
Sacramento, CA 95823-4832
Phone (916) 410-2449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XDJ90008931D | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | sacramento |
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": "1579824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1306476734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6351 WESTHOLME WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958234832",
"telephone_number": "916-410-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 MAIN ST",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "95678",
"telephone_number": "916-410-2449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "DESERAY",
"middle_name": "JOYCELIN R",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-24",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "XDJ90008931D",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "sacramento",
"affiliation": "N",
"address_1": "6351 Westholme Way",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "958234832",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.