Individual provider Active NPI

Jalyssa Diana Rodriguez

  • Behavior Technician
  • Palm Beach Gardens, FL
National Provider Identifier
1316505936
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
9000 Burma Rd Ste 109
Palm Beach Gardens, FL 33403-1606
Phone
(561) 508-6122
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

9000 Burma Rd Ste 109
Palm Beach Gardens, FL 33403-1606

Mailing address

9000 Burma Rd Ste 109
Palm Beach Gardens, FL 33403-1606
Phone (561) 508-6122

Other practice location 1

5338 White Oleander
West Palm Beach, FL 33415-4475
Phone (954) 701-4358

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1316505936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 BURMA RD STE 109",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031606",
            "telephone_number": "561-508-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 BURMA RD STE 109",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031606",
            "telephone_number": "561-508-6122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5338 White Oleander",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334154475",
            "country_code": "US",
            "telephone_number": "954-701-4358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JALYSSA",
        "middle_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.

Verify at the official NPI Registry.