Individual provider Active NPI

Jessica Ivett Andrade

  • Assistant Behavior Analyst
  • San Mateo, CA
National Provider Identifier
1467938688
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
424 Peninsula Ave
San Mateo, CA 94401-1653
Phone
(650) 289-4396
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CA
Assistant Behavior Analyst 106E00000X CA Primary
Behavior Technician 106S00000X CA

Addresses

Primary practice location

424 Peninsula Ave
San Mateo, CA 94401-1653

Mailing address

2048 Miller Ave
Modesto, CA 95354-2925
Phone (209) 289-4111

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1467938688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 MILLER AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542925",
            "telephone_number": "209-289-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 PENINSULA AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944011653",
            "telephone_number": "650-289-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "JESSICA",
        "middle_name": "IVETT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.