Individual provider Active NPI

Moncerrad Juarez Jaimes

  • Behavior Technician
  • Stockton, CA
National Provider Identifier
1386554657
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4719 Quail Lakes Dr Ste G409
Stockton, CA 95207-8140
Phone
(209) 208-4804
NPI assigned
Sep 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 CA Primary

Addresses

Primary practice location

4719 Quail Lakes Dr Ste G409
Stockton, CA 95207-8140

Mailing address

4719 Quail Lakes Dr Ste G409
Stockton, CA 95207-8140
Phone (209) 208-4804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1386554657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR STE G409",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078140",
            "telephone_number": "209-208-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR STE G409",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078140",
            "telephone_number": "209-208-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ JAIMES",
        "first_name": "MONCERRAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.