Individual provider Active NPI

Macee Elizabeth Pittman

  • Behavior Technician
  • San Clemente, CA
National Provider Identifier
1467020305
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1319 Calle Avanzado
San Clemente, CA 92673-6351
Phone
(949) 272-6146
Fax
(888) 847-8864
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

1319 Calle Avanzado
San Clemente, CA 92673-6351

Mailing address

1831 Golden Eagle Way Ste 34
Fleming Island, FL 32003-4340
Phone (904) 579-4770

Other practice location 1

1831 Golden Eagle Way Ste 34
Fleming Island, FL 32003-4340
Phone (904) 579-4779

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evolutions ABA Inc Behavior Technician CurrentSince Oct 15, 2023 Accepting new patients

Locations

1319 Calle Avanzado
San Clemente, CA 92673
Phone (949) 272-6146

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1467020305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 GOLDEN EAGLE WAY STE 34",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034340",
            "telephone_number": "904-579-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 CALLE AVANZADO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736351",
            "telephone_number": "949-272-6146",
            "fax_number": "888-847-8864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1831 Golden Eagle Way Ste 34",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034340",
            "country_code": "US",
            "telephone_number": "904-579-4779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "MACEE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.