Individual provider Active NPI

Tamby Norohanitra Randrianantenaina

  • Behavior Technician
  • Fairfax, VA
National Provider Identifier
1538719547
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
C62484839 Issued in VA
Practice address
10340 Democracy LN Ste 102B103
Fairfax, VA 22030-2518
Phone
(571) 386-0871
NPI assigned
Sep 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X C62484839 VA Primary

Addresses

Primary practice location

10340 Democracy LN Ste 102B103
Fairfax, VA 22030-2518

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345

Other practice location 1

3400 State St Ste G750
Salem, OR 97301-7012
Phone (971) 273-7502

Other practice location 2

10340 Democracy Ln Ste 102B103
Fairfax, VA 22030-2518
Phone (571) 386-0871

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
C62484839VAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1538719547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 DEMOCRACY LN STE 102B103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302518",
            "telephone_number": "571-386-0871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 State St Ste G750",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973017012",
            "country_code": "US",
            "telephone_number": "971-273-7502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10340 Democracy Ln Ste 102B103",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220302518",
            "country_code": "US",
            "telephone_number": "571-386-0871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDRIANANTENAINA",
        "first_name": "TAMBY",
        "middle_name": "NOROHANITRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "C62484839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.