Individual provider Active NPI

Adelita Rose Spears-Diaz

  • Behavior Technician
  • Vancouver, WA
National Provider Identifier
1457198616
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
120 NE 136TH Ave Ste 220
Vancouver, WA 98684-6951
Phone
(360) 952-7060
NPI assigned
Jul 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

120 NE 136TH Ave Ste 220
Vancouver, WA 98684-6951

Mailing address

1902 NE 124TH Ave
Vancouver, WA 98684-5559

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": "1720828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1457198616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 NE 124TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NE 136TH AVE STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846951",
            "telephone_number": "360-952-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS-DIAZ",
        "first_name": "ADELITA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-13",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.