Individual provider Active NPI

Jacqueline Beatriz Valdes Chavez

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1356891550
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
18505 NW 75TH PL
Hialeah, FL 33015-2961
Phone
(786) 479-0029
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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 Primary

Addresses

Primary practice location

18505 NW 75TH PL
Hialeah, FL 33015-2961

Mailing address

10345 SW 135TH PL
Miami, FL 33186-2842
Phone (786) 800-0842

Other identifiers 1

IdentifierTypeStateIssuer
019001700MedicaidFL

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1356891550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10345 SW 135TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862842",
            "telephone_number": "786-800-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18505 NW 75TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152961",
            "telephone_number": "786-479-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES CHAVEZ",
        "first_name": "JACQUELINE",
        "middle_name": "BEATRIZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019001700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.