NPIMap

Individual provider Active NPI

Christina Rose Comic

  • Behavior Technician
  • Fairfield, CA
National Provider Identifier
1396258471
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
744 Empire St Ste 160
Fairfield, CA 94533-5562
Phone
(707) 399-9413
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

744 Empire St Ste 160
Fairfield, CA 94533-5562

Mailing address

2730 Shadelands Dr BLDG 10
Walnut Creek, CA 94598-2538

Other practice location 1

2595 International Blvd
Oakland, CA 94601-1509
Phone (510) 437-8950

Other practice location 2

1255 Allston Way
Berkeley, CA 94702-1833
Phone (510) 849-1402

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

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Youth Alternatives PastSince May 21, 2023 Accepting new patients
Brighter Beginnings PastSince Dec 1, 2020 Accepting new patients
Easter Seals Bay Area PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1396258471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 SHADELANDS DR BLDG 10",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 EMPIRE ST STE 160",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335562",
            "telephone_number": "707-399-9413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2595 International Blvd",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946011509",
            "country_code": "US",
            "telephone_number": "510-437-8950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 Allston Way",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947021833",
            "country_code": "US",
            "telephone_number": "510-849-1402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMIC",
        "first_name": "CHRISTINA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.