Individual provider Active NPI

Bradley Rafael Lohmeyer

  • Behavior Technician
  • Ontario, CA
National Provider Identifier
1477251858
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3333 Concours Ste 4102
Ontario, CA 91764-6564
Phone
(909) 240-1764
Fax
(909) 259-2369
NPI assigned
Feb 16, 2023
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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 NU Primary

Addresses

Primary practice location

3333 Concours Ste 4102
Ontario, CA 91764-6564

Mailing address

12645 Sunny Vista Ave
Victorville, CA 92395-9443
Phone (760) 780-9413

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1477251858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12645 SUNNY VISTA AVE",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923959443",
            "telephone_number": "760-780-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CONCOURS STE 4102",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917646564",
            "telephone_number": "909-240-1764",
            "fax_number": "909-259-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOHMEYER",
        "first_name": "BRADLEY",
        "middle_name": "RAFAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.