Angela Maija-Liisa Penn

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-119255 Issued in VA

Practice address

11 Hope Rd Ste 215
Stafford, VA 22554-7287

Phone

(540) 225-1020

NPI assigned

Apr 29, 2020

Last updated

Mar 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1376164434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11415 LONE PINE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224080482",
            "telephone_number": "540-538-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HOPE RD STE 215",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547287",
            "telephone_number": "540-225-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11415 Lone Pine Ct",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224080482",
            "country_code": "US",
            "telephone_number": "540-412-8431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "ANGELA",
        "middle_name": "MAIJA-LIISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT-20-119255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Residential Care
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• Michelle Perdew, FNP
• Liza Perez, RN
• Natalie Perez
• Paola Perez

• Behavior Technician in Stafford, VA
• Providers in Stafford, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.