Organization Active NPI

Cortica Behavioral Health Inc.

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1417517541
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
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

Updated by the provider on Jun 20, 2019

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)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
281234M001OtherANTHEM BLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://members.centralreach.com/#login Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.