Individual provider Active NPI

Shedith Cruz Garcia

  • Assistant Behavior Analyst
  • Gardena, CA
National Provider Identifier
1407511835
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
1411 W 190TH St Ste 110
Gardena, CA 90248-4370
Phone
(310) 719-3908
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Primary

Addresses

Primary practice location

1411 W 190TH St Ste 110
Gardena, CA 90248-4370

Mailing address

1411 W 190TH St Ste 110
Gardena, CA 90248-4370

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1407511835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W 190TH ST STE 110",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W 190TH ST STE 110",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484370",
            "telephone_number": "310-719-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ GARCIA",
        "first_name": "SHEDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.