Individual provider Active NPI

Maria Carmen Rivera-Tello, B.A

  • Behavior Technician
  • Fremont, CA
National Provider Identifier
1508095662
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
39420 Liberty St
Suite 140
Fremont, CA 94538-2200
Phone
(510) 745-9151
Fax
(510) 745-9152
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

39420 Liberty St
Suite 140
Fremont, CA 94538-2200

Mailing address

39420 Liberty St
Suite 140
Fremont, CA 94538-2200
Phone (510) 745-9151

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
Credentials
Bachelor of Arts

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1508095662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST",
            "address_2": "SUITE 140",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382200",
            "telephone_number": "510-745-9151",
            "fax_number": "510-745-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST",
            "address_2": "SUITE 140",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382200",
            "telephone_number": "510-745-9151",
            "fax_number": "510-745-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-TELLO",
        "first_name": "MARIA",
        "middle_name": "CARMEN",
        "credential": "B.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.