Individual provider Active NPI

Keenya McDaniel

  • Behavior Technician
  • Citrus Heights, CA
National Provider Identifier
1396241352
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
6400 Tupelo Dr
Citrus Heights, CA 95621-1741
Phone
(916) 729-3098
NPI assigned
Mar 30, 2018
Last updated
Mar 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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 NU Primary

Addresses

Primary practice location

6400 Tupelo Dr
Citrus Heights, CA 95621-1741

Mailing address

6305 San Pablo Dr Apt 209
Citrus Heights, CA 95610-5704
Phone (916) 793-8579

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": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1396241352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6305 SAN PABLO DR APT 209",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956105704",
            "telephone_number": "916-793-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 TUPELO DR",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211741",
            "telephone_number": "916-729-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "KEENYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.