Active NPI
Aaron I Rudy
- Behavior Analyst
- San Rafael, CA
National Provider Identifier
1346855772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-66738
- Practice address
- 4000 Civic Center Dr Ste 100
San Rafael, CA 94903-4151 - Phone
- (628) 877-0040
- NPI assigned
- Sep 11, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-31955 | CA | |
| Behavior Analyst | 103K00000X | 1-23-66738 | CA | Primary |
Addresses
Primary practice location
4000 Civic Center Dr Ste 100
San Rafael, CA 94903-4151
Mailing address
55 Corte Real Apt 20
Greenbrae, CA 94904-2145
Phone (510) 290-2593
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 |
|---|---|---|---|
| RBT-17-31955 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1346855772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 CORTE REAL APT 20",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949042145",
"telephone_number": "510-290-2593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 CIVIC CENTER DR STE 100",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949034151",
"telephone_number": "628-877-0040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDY",
"first_name": "AARON",
"middle_name": "I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-17-31955",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-23-66738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.