Individual provider Active NPI

Koryna Schraeder

  • Behavior Technician
  • Lompoc, CA
National Provider Identifier
1336732296
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3757 Constellation Rd
Lompoc, CA 93436-1401
Phone
(805) 979-9941
NPI assigned
Feb 11, 2021
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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 NU Primary

Addresses

Primary practice location

3757 Constellation Rd
Lompoc, CA 93436-1401

Mailing address

2342 Professional Pkwy Ste 300
Santa Maria, CA 93455-6819
Phone (805) 979-9941

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": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1336732296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 PROFESSIONAL PKWY STE 300",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934556819",
            "telephone_number": "805-979-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3757 CONSTELLATION RD",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934361401",
            "telephone_number": "805-979-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAEDER",
        "first_name": "KORYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.