Active NPI
Cortica Behavioral Health Inc.
- Behavior Technician
- San Diego, CA
National Provider Identifier
1417517541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Legal business name
- CORTICA BEHAVIORAL HEALTH INC.
- Practice address
- 7090 Miratech Dr
San Diego, CA 92121-3109 - Phone
- (858) 304-6440
- NPI assigned
- Jun 20, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chaeli Reyes
- Title
- Registered Behavior Technician
- Phone
- (818) 620-5362
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
7090 Miratech Dr
San Diego, CA 92121-3109
Mailing address
3128 Cowley Way Apt 3
San Diego, CA 92117-6559
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281234M001 | Other | ANTHEM BLUE CROSS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://members.centralreach.com/#login | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560988800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560988800000",
"number": "1417517541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3128 COWLEY WAY APT 3",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7090 MIRATECH DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213109",
"telephone_number": "858-304-6440"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORTICA BEHAVIORAL HEALTH INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-20",
"last_updated": "2019-06-20",
"status": "A",
"authorized_official_last_name": "REYES",
"authorized_official_first_name": "CHAELI",
"authorized_official_title_or_position": "REGISTERED BEHAVIOR TECHNICIAN",
"authorized_official_telephone_number": "818-620-5362"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "281234M001",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://members.centralreach.com/#login",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "API",
"address_1": "7090 Miratech Dr",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921213109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.