Active NPI
Alyssa Ashley Mandich
- Behavior Technician
- Rancho Cordova, CA
National Provider Identifier
1508554866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 10390 Coloma Rd Ste 100
Rancho Cordova, CA 95670-2152 - Phone
- (877) 910-6538
- NPI assigned
- Apr 25, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
10390 Coloma Rd Ste 100
Rancho Cordova, CA 95670-2152
Mailing address
1040 Rio LN Apt 20
Sacramento, CA 95822-1741
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682467200000",
"number": "1508554866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 RIO LN APT 20",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958221741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10390 COLOMA RD STE 100",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956702152",
"telephone_number": "877-910-6538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDICH",
"first_name": "ALYSSA",
"middle_name": "ASHLEY",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-25",
"last_updated": "2023-04-26",
"certification_date": "2023-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"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 Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.