Active NPI
Jamile Urquilla
- Behavior Technician
- Fullerton, CA
National Provider Identifier
1447714340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-16-21306
- Practice address
- 505 E Commonwealth Ave
Fullerton, CA 92832-4009 - Phone
- (714) 773-0077
- Fax
- (714) 773-0067
- NPI assigned
- Jan 24, 2019
- 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-16-21306 | CA | Primary |
Addresses
Primary practice location
505 E Commonwealth Ave
Fullerton, CA 92832-4009
Mailing address
1435 N Harbor Blvd # 124
Fullerton, CA 92835-4105
Phone (714) 773-0077
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-16-21306 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sage Behavior Services, Inc | 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": "1548288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548288000000",
"number": "1447714340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1435 N HARBOR BLVD # 124",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928354105",
"telephone_number": "714-773-0077",
"fax_number": "714-773-0067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 E COMMONWEALTH AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928324009",
"telephone_number": "714-773-0077",
"fax_number": "714-773-0067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URQUILLA",
"first_name": "JAMILE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-24",
"last_updated": "2019-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-16-21306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.