Individual provider Active NPI

Amanda Irao

  • Other Technician
  • Concord, CA
National Provider Identifier
1407390214
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
License
RBT-16-22981 Issued in CA
Practice address
1070 Concord Ave Ste 120
Concord, CA 94520-5695
Phone
(877) 264-6747
Fax
(877) 539-7730
NPI assigned
Dec 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X RBT-16-22981 CA Primary

Addresses

Primary practice location

1070 Concord Ave Ste 120
Concord, CA 94520-5695

Mailing address

36 Monterey Blvd Ste a
San Francisco, CA 94131-3235
Phone (877) 264-6747

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

LicenseStateTypeSpecialty
RBT-16-22981CAMDOther Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Kyo Autism Therapy, LLC Past Accepting new patients

Organizations & group practices 1

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": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1407390214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MONTEREY BLVD STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941313235",
            "telephone_number": "877-264-6747",
            "fax_number": "877-539-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 CONCORD AVE STE 120",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205695",
            "telephone_number": "877-264-6747",
            "fax_number": "877-539-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRAO",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "CA",
            "license": "RBT-16-22981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.