Individual provider Active NPI

Katie Jo Del Rio

  • Other Technician
  • Fountain Valley, CA
National Provider Identifier
1346789112
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
11037 Warner Ave # 339
Fountain Valley, CA 92708-4007
Phone
(800) 273-4292
Fax
(949) 253-4627
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X HI Primary

Addresses

Primary practice location

11037 Warner Ave # 339
Fountain Valley, CA 92708-4007

Mailing address

4125 Kahakaha LN
Kailua, HI 96734-6840
Phone (808) 375-4925

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

Practice roles

OrganizationSpecialtyStatusNew patients
Footprints Behavioral Interventions, Inc. Past Accepting new patients
Footprints Behavior Interventions PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1346789112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 KAHAKAHA LN",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967346840",
            "telephone_number": "808-375-4925",
            "fax_number": "949-253-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE # 339",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "800-273-4292",
            "fax_number": "949-253-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL RIO",
        "first_name": "KATIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.

Verify at the official NPI Registry.