Individual provider Active NPI

Gretha Rojas Ulloa

  • Behavior Technician
  • Scottdale, GA
National Provider Identifier
1326802075
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-213696 Issued in GA
Practice address
489 Lantern Wood Dr
Scottdale, GA 30079-6800
Phone
(786) 326-5711
NPI assigned
Feb 12, 2024
Last updated
Feb 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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 RBT-22-213696 GA Primary

Addresses

Primary practice location

489 Lantern Wood Dr
Scottdale, GA 30079-6800

Mailing address

3111 Colonial Way Apt B
Chamblee, GA 30341-5315
Phone (786) 326-5711

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

State licenses

LicenseStateTypeSpecialty
RBT-22-213696GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1326802075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 COLONIAL WAY APT B",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303415315",
            "telephone_number": "786-326-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 LANTERN WOOD DR",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "300796800",
            "telephone_number": "786-326-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJAS ULLOA",
        "first_name": "GRETHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-22-213696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.

Verify at the official NPI Registry.