Active NPI
Carmen Contreras-Jeronimo
- Behavior Technician
- San Mateo, CA
National Provider Identifier
1396386470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- F3620903
- Practice address
- 800 S Claremont St
San Mateo, CA 94402-1451 - Phone
- (650) 281-2631
- NPI assigned
- Sep 30, 2019
- 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 | F3620903 | CA | Primary |
Addresses
Primary practice location
800 S Claremont St
San Mateo, CA 94402-1451
Mailing address
116 Bonita LN
Moss Beach, CA 94038-9766
Phone (650) 438-6188
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3620903 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1396386470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 BONITA LN",
"city": "MOSS BEACH",
"state": "CA",
"postal_code": "940389766",
"telephone_number": "650-438-6188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S CLAREMONT ST",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944021451",
"telephone_number": "650-281-2631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTRERAS-JERONIMO",
"first_name": "CARMEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-30",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "F3620903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.