Active NPI
Jacquelyn Marlene Perez
- Assistant Behavior Analyst
- Long Beach, CA
National Provider Identifier
1497526859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 12046318
- Practice address
- 5526 Lemon Ave
Long Beach, CA 90805-5440 - Phone
- (562) 728-7150
- NPI assigned
- Jan 12, 2024
- 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 |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 12046318 | CA | Primary |
Addresses
Primary practice location
5526 Lemon Ave
Long Beach, CA 90805-5440
Mailing address
21515 Hawthorne Blvd
Torrance, CA 90503
Phone (424) 571-2618
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 |
|---|---|---|---|
| 12046318 | CA | MD | Assistant Behavior Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1497526859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21515 HAWTHORNE BLVD",
"city": "TORRANCE",
"state": "CA",
"postal_code": "90503",
"telephone_number": "424-571-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5526 LEMON AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908055440",
"telephone_number": "562-728-7150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JACQUELYN",
"middle_name": "MARLENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-12",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "CA",
"license": "12046318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.