Active NPI
Isyss Adams
- Behavior Technician
- Concord, CA
National Provider Identifier
1407500093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1200 Concord Ave Ste 100
Concord, CA 94520-4969 - Phone
- (510) 268-8120
- NPI assigned
- Feb 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | NYCPS-P-4674 | NY | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Mailing address
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Phone (510) 268-8120
Other practice location 1
25 Elm Pl Fl 6
Brooklyn, NY 11201-5826
Phone (718) 852-5212
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 |
|---|---|---|---|
| NYCPS-P-4674 | NY | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heights-Hill Mental Health Service SBPC Community Advisory Board, Inc. | Peer Specialist | Current | Accepting new patients |
Locations
25 Flatbush Ave
Ste 3
Brooklyn, NY 11217
Phone (718) 852-2584
25 Elm Pl
Fl 6
Brooklyn, NY 11201
Phone (718) 593-9923
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.
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1114313475
Peer Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1407500093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CONCORD AVE STE 100",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204969",
"telephone_number": "510-268-8120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CONCORD AVE STE 100",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204969",
"telephone_number": "510-268-8120"
}
],
"practiceLocations": [
{
"address_1": "25 Elm Pl Fl 6",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112015826",
"country_code": "US",
"telephone_number": "718-852-5212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ADAMS",
"first_name": "ISYSS",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-11",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NY",
"license": "NYCPS-P-4674",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"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 Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.