Active NPI
Ronda Davenport
- Behavior Technician
- Camarillo, CA
National Provider Identifier
1497280853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- PT28358
- Practice address
- 333 Skyway Dr
Camarillo, CA 93010-8552 - Phone
- (805) 383-1155
- NPI assigned
- Apr 24, 2017
- Sex
- Female
- Sole proprietor
- No
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 | PT28358 | CA | Primary |
Addresses
Primary practice location
333 Skyway Dr
Camarillo, CA 93010-8552
Mailing address
333 Skyway Dr
Camarillo, CA 93010-8552
Phone (805) 383-1155
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 |
|---|---|---|---|
| PT28358 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian J McKinney, MD Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Camarillo, CA
- NPI 1427531425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492992000000",
"number": "1497280853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 SKYWAY DR",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930108552",
"telephone_number": "805-383-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 SKYWAY DR",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930108552",
"telephone_number": "805-383-1155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "RONDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-24",
"last_updated": "2017-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "PT28358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.