Alisha Modupe Alli-Short

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107

Phone

(877) 418-2978

NPI assigned

Jan 19, 2022

Last updated

Jan 19, 2022By the provider in NPPES

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

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1326790619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 FRANKLIN ST # 100-182",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123488",
            "telephone_number": "510-406-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 GRAND CANAL BLVD STE 2",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078107",
            "telephone_number": "877-418-2978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Fairway Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411834",
            "country_code": "US",
            "telephone_number": "877-419-2978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLI-SHORT",
        "first_name": "ALISHA",
        "middle_name": "MODUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.