Individual provider Active NPI

Jacqueline Gazelle Romero, SLP ASSISTANT

  • Behavior Technician
  • El Paso, TX
National Provider Identifier
1508306796
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4601 Hondo Pass Dr Ste a
El Paso, TX 79904
Phone
(915) 920-7804
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 37728 TX
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

4601 Hondo Pass Dr Ste a
El Paso, TX 79904

Mailing address

4109 Hallmark CT
El Paso, TX 79904-1217
Phone (915) 920-7804

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

LicenseStateTypeSpecialty
37728TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1508306796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 HALLMARK CT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799041217",
            "telephone_number": "915-920-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 HONDO PASS DR STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79904",
            "telephone_number": "915-920-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "JACQUELINE",
        "middle_name": "GAZELLE",
        "credential": "SLP ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "37728",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.