Active NPI
Makruma Mohamed Hassan
- Behavior Technician
- San Diego, CA
National Provider Identifier
1376365353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3878 Ruffin Rd Suite B
San Diego, CA 92105 - Phone
- (619) 795-9925
- NPI assigned
- Oct 30, 2024
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
3878 Ruffin Rd Suite B
San Diego, CA 92105
Mailing address
3810 Winona Ave
Apt 206
San Diego, CA 92105
Phone (619) 770-2383
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": "1730246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1376365353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3810 WINONA AVE",
"address_2": "APT 206",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92105",
"telephone_number": "619-770-2383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3878 RUFFIN RD SUITE B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92105",
"telephone_number": "619-795-9925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSAN",
"first_name": "MAKRUMA",
"middle_name": "MOHAMED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-30",
"last_updated": "2024-10-30",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.