Active NPI
Kevwe Anigbogu
- Behavior Technician
- Huntington Beach, CA
National Provider Identifier
1447079587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-239608
- Practice address
- 16541 Gothard St Ste 110
Huntington Beach, CA 92647-4472 - Phone
- (877) 264-6747
- NPI assigned
- Oct 7, 2024
- 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 | RBT-22-239608 | CA | Primary |
Addresses
Primary practice location
16541 Gothard St Ste 110
Huntington Beach, CA 92647-4472
Mailing address
1540 W Ball Rd Apt 14N
Anaheim, CA 92802-1615
Phone (951) 501-9681
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 |
|---|---|---|---|
| RBT-22-239608 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1447079587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 W BALL RD APT 14N",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928021615",
"telephone_number": "951-501-9681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16541 GOTHARD ST STE 110",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926474472",
"telephone_number": "877-264-6747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANIGBOGU",
"first_name": "KEVWE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-07",
"last_updated": "2024-10-07",
"certification_date": "2024-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-22-239608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.