Isabella Johanna Alicia Bocanegra

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

731 Bielenberg Dr Ste 102-104
Woodbury, MN 55125-1700

Phone

(612) 445-8326

NPI assigned

Oct 9, 2023

Last updated

Oct 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1457132284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19466 BAUER CIR",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550339640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR STE 102-104",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "612-445-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCANEGRA",
        "first_name": "ISABELLA",
        "middle_name": "JOHANNA ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.