Active NPI
Jeffrey Dean Whitney
- Behavior Technician
- Crestline, CA
National Provider Identifier
1497215420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 22792 Laurel LN
Crestline, CA 92325 - Phone
- (909) 496-4549
- NPI assigned
- Mar 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
22792 Laurel LN
Crestline, CA 92325
Mailing address
PO Box 1195
Crestline, CA 92325-1195
Phone (909) 496-4549
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": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1497215420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1195",
"city": "CRESTLINE",
"state": "CA",
"postal_code": "923251195",
"telephone_number": "909-496-4549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22792 LAUREL LN",
"city": "CRESTLINE",
"state": "CA",
"postal_code": "92325",
"telephone_number": "909-496-4549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITNEY",
"first_name": "JEFFREY",
"middle_name": "DEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-25",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestline, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.