Active NPI
Chanel Cundy
- Behavior Technician
- Upland, CA
National Provider Identifier
1326859638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- Y4771374
- Practice address
- 958 W 22ND St
Upland, CA 91784-1229 - Phone
- (909) 552-0829
- NPI assigned
- Jan 16, 2025
- 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 | Y4771374 | CA | Primary |
Addresses
Primary practice location
958 W 22ND St
Upland, CA 91784-1229
Mailing address
958 W 22ND St
Upland, CA 91784-1229
Phone (909) 552-0829
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
| License | State | Type | Specialty |
|---|---|---|---|
| Y4771374 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1326859638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "958 W 22ND ST",
"city": "UPLAND",
"state": "CA",
"postal_code": "917841229",
"telephone_number": "909-552-0829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "958 W 22ND ST",
"city": "UPLAND",
"state": "CA",
"postal_code": "917841229",
"telephone_number": "909-552-0829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNDY",
"first_name": "CHANEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-16",
"last_updated": "2025-01-16",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "Y4771374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.