Individual provider Active NPI

Katie Pamela Pinos Hernandez

  • Behavior Technician
  • Eagan, MN
National Provider Identifier
1376356519
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1875 Plaza Dr Ste 100
Eagan, MN 55122-2613
Phone
(612) 800-1948
Fax
(651) 389-9229
NPI assigned
Jan 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

1875 Plaza Dr Ste 100
Eagan, MN 55122-2613

Mailing address

1875 Plaza Dr Ste 100
Eagan, MN 55122-2613
Phone (612) 800-1948

Other identifiers 1

IdentifierTypeStateIssuer
A762977400MedicaidMN

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": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1376356519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 PLAZA DR STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222613",
            "telephone_number": "612-800-1948",
            "fax_number": "651-389-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 PLAZA DR STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222613",
            "telephone_number": "612-800-1948",
            "fax_number": "651-389-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINOS HERNANDEZ",
        "first_name": "KATIE",
        "middle_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A762977400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.