Active NPI
Jaqueline Medrano, BEHAVIOR ANALYST
- Behavior Analyst
- Cypress, TX
National Provider Identifier
1447908504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 15103 Mason Rd Ste C-1
Cypress, TX 77433-6755 - Phone
- (281) 602-3565
- NPI assigned
- Mar 16, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
15103 Mason Rd Ste C-1
Cypress, TX 77433-6755
Mailing address
12430 Grant Rd Ste a
Cypress, TX 77429-7912
Phone (855) 782-7822
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734566400000",
"number": "1447908504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12430 GRANT RD STE A",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774297912",
"telephone_number": "855-782-7822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15103 MASON RD STE C-1",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774336755",
"telephone_number": "281-602-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDRANO",
"first_name": "JAQUELINE",
"credential": "BEHAVIOR ANALYST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-16",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.