Active NPI
Jessica Wise-Graham
- Behavior Technician
- San Diego, CA
National Provider Identifier
1427548288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3505 Camino del Rio S Ste 200
San Diego, CA 92108-4016 - Phone
- (888) 616-0864
- Fax
- (888) 616-0864
- NPI assigned
- May 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
3505 Camino del Rio S Ste 200
San Diego, CA 92108-4016
Mailing address
3505 Camino del Rio S Ste 200
San Diego, CA 92108-4016
Phone (888) 616-0864
Other names 1
- Ms. Jessica Wise
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior All-Stars LLC | Behavior Technician | 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": "1526428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526428800000",
"number": "1427548288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3505 CAMINO DEL RIO S STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084016",
"telephone_number": "888-616-0864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3505 CAMINO DEL RIO S STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084016",
"telephone_number": "888-616-0864",
"fax_number": "888-616-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE-GRAHAM",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-16",
"last_updated": "2018-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "WISE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}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 May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.