Individual provider Active NPI

Mikayla Marie Nonog

  • Behavior Technician
  • Rohnert Park, CA
National Provider Identifier
1386317584
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2 Padre Pkwy Ste 101
Rohnert Park, CA 94928-2114
Phone
(510) 268-8120
NPI assigned
Jul 26, 2021
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

2 Padre Pkwy Ste 101
Rohnert Park, CA 94928-2114

Mailing address

9250 Boscastle Way
Sacramento, CA 95829-6020
Phone (916) 544-7757

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1386317584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 BOSCASTLE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958296020",
            "telephone_number": "916-544-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PADRE PKWY STE 101",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282114",
            "telephone_number": "510-268-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NONOG",
        "first_name": "MIKAYLA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.