Active NPI
Khasydi Persaud, CBT, RBT
- Behavior Technician
- Tacoma, WA
National Provider Identifier
1407317662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4301 S Pine St Ste 505
Tacoma, WA 98409-7208 - Phone
- (253) 292-4354
- NPI assigned
- Mar 28, 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 | Primary |
Addresses
Primary practice location
4301 S Pine St Ste 505
Tacoma, WA 98409-7208
Mailing address
1122 S 202ND St
Seatac, WA 98198-4117
Other practice location 1
92-461 Makakilo Dr
Kapolei, HI 96707-1270
Phone (808) 678-3754
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": "1553731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670716800000",
"number": "1407317662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 S 202ND ST",
"city": "SEATAC",
"state": "WA",
"postal_code": "981984117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 S PINE ST STE 505",
"city": "TACOMA",
"state": "WA",
"postal_code": "984097208",
"telephone_number": "253-292-4354"
}
],
"practiceLocations": [
{
"address_1": "92-461 Makakilo Dr",
"address_purpose": "LOCATION",
"city": "Kapolei",
"state": "HI",
"postal_code": "967071270",
"country_code": "US",
"telephone_number": "808-678-3754",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERSAUD",
"first_name": "KHASYDI",
"credential": "CBT, RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-28",
"last_updated": "2022-12-11",
"certification_date": "2022-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.