Active NPI
Lauryn Mandac Villablanca
- Behavior Technician
- Bellingham, WA
National Provider Identifier
1346759834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1616 Cornwall Ave Ste 100
Bellingham, WA 98225-4642 - Phone
- (360) 305-3275
- NPI assigned
- Sep 27, 2017
- 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 | Primary |
Addresses
Primary practice location
1616 Cornwall Ave Ste 100
Bellingham, WA 98225-4642
Mailing address
4111 Consolidation Ave Apt 103
Bellingham, WA 98229-2860
Phone (425) 306-4777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | WA |
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": "1506470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506470400000",
"number": "1346759834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 CONSOLIDATION AVE APT 103",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982292860",
"telephone_number": "425-306-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 CORNWALL AVE STE 100",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982254642",
"telephone_number": "360-305-3275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLABLANCA",
"first_name": "LAURYN",
"middle_name": "MANDAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-27",
"last_updated": "2017-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.