Active NPI
Nayeli Aide Fredericks, M.A., BCBA
- Behavior Analyst
- Spokane, WA
National Provider Identifier
1457746455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 60759865
- Practice address
- 6608 S Meadow St
Spokane, WA 99224-8495 - Phone
- (775) 762-6932
- NPI assigned
- Apr 6, 2015
- Reactivated
- May 13, 2021
- 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 Analyst | 103K00000X | 60759865 | WA | Primary |
Addresses
Primary practice location
6608 S Meadow St
Spokane, WA 99224-8495
Mailing address
2910 E 57TH Ave # 5-108
Spokane, WA 99223-7028
Phone (509) 795-1967
Other practice location 1
300 N Argonne Rd
Suite 204
Spokane Valley, WA 99212-2839
Phone (208) 699-2595
Other practice location 2
2910 E 57th Ave # 5-108
Spokane, WA 99223-7028
Phone (509) 795-1967
Other names 1
- Miss Nayeli Aide Becerra
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60759865 | WA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1457746455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 E 57TH AVE # 5-108",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992237028",
"telephone_number": "509-795-1967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6608 S MEADOW ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992248495",
"telephone_number": "775-762-6932"
}
],
"practiceLocations": [
{
"address_1": "300 N Argonne Rd",
"address_2": "Suite 204",
"address_purpose": "LOCATION",
"city": "Spokane Valley",
"state": "WA",
"postal_code": "992122839",
"country_code": "US",
"telephone_number": "208-699-2595",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2910 E 57th Ave # 5-108",
"address_purpose": "LOCATION",
"city": "Spokane",
"state": "WA",
"postal_code": "992237028",
"country_code": "US",
"telephone_number": "509-795-1967",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FREDERICKS",
"first_name": "NAYELI",
"middle_name": "AIDE",
"name_prefix": "Mrs.",
"credential": "M.A., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"deactivation_date": "2021-03-25",
"reactivation_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "60759865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NAYELI",
"last_name": "BECERRA",
"middle_name": "AIDE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.