Aridesmi Anchondo Palacios

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

502 W Aten Rd Ste 105
Imperial, CA 92251-9423

Phone

(760) 592-0088

Fax

(760) 370-9236

NPI assigned

Feb 2, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fred Finch Youth Center Cares

  • Behavior Analyst
  • San Diego, CA
  • NPI 1710439559
  NPD

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1376249235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 COMPLEX DR STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W ATEN RD STE 105",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922519423",
            "telephone_number": "760-592-0088",
            "fax_number": "760-370-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCHONDO PALACIOS",
        "first_name": "ARIDESMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Imperial, CA
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.