Active NPI
Ieshia Shadara Neal
- Behavior Technician
- Valencia, CA
National Provider Identifier
1497252902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-50787
- Practice address
- 23502 Lyons Ave
Ste 304
Valencia, CA 91321 - Phone
- (661) 702-0166
- NPI assigned
- Apr 11, 2018
- Sex
- Female
- 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 | RBT-18-50787 | CA | Primary |
Addresses
Primary practice location
23502 Lyons Ave
Ste 304
Valencia, CA 91321
Mailing address
45417 30TH St W Apt 105
Lancaster, CA 93536-6179
Phone (661) 450-7776
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-50787 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1497252902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45417 30TH ST W APT 105",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935366179",
"telephone_number": "661-450-7776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23502 LYONS AVE",
"address_2": "STE 304",
"city": "VALENCIA",
"state": "CA",
"postal_code": "91321",
"telephone_number": "661-702-0166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEAL",
"first_name": "IESHIA",
"middle_name": "SHADARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-11",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-18-50787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.