Individual provider Active NPI

Yulissa Santana Quintero

  • Assistant Behavior Analyst
  • Tigard, OR
National Provider Identifier
1346833142
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
ABA-IN-10212299 Issued in OR
Practice address
9912 SW Scott CT
Tigard, OR 97223-5327
Phone
(503) 505-8099
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X ABA-IN-10212299 OR Primary

Addresses

Primary practice location

9912 SW Scott CT
Tigard, OR 97223-5327

Mailing address

9912 SW Scott CT
Tigard, OR 97223-5327

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
ABA-IN-10212299ORMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1346833142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9912 SW SCOTT CT",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9912 SW SCOTT CT",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235327",
            "telephone_number": "503-505-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA QUINTERO",
        "first_name": "YULISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "OR",
            "license": "ABA-IN-10212299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.