Active NPI
Juan Jose Rafael Jr., RBT-18-59188
- Behavior Technician
- Irvine, CA
National Provider Identifier
1366950297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-59188
- Practice address
- 1063 McGaw Ave Ste 100
Irvine, CA 92614-5554 - Phone
- (714) 834-1111
- NPI assigned
- Jan 12, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-59188 | CA | Primary |
Addresses
Primary practice location
1063 McGaw Ave Ste 100
Irvine, CA 92614-5554
Mailing address
2973 Harbor Blvd # 136
Costa Mesa, CA 92626-3912
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-18-59188 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1366950297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2973 HARBOR BLVD # 136",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1063 MCGAW AVE STE 100",
"city": "IRVINE",
"state": "CA",
"postal_code": "926145554",
"telephone_number": "714-834-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFAEL",
"first_name": "JUAN",
"middle_name": "JOSE",
"name_suffix": "Jr.",
"credential": "RBT-18-59188",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-12",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-18-59188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.