Individual provider Active NPI

Ania Alicia Fresco Balladares

  • Behavior Technician
  • Palm Springs, FL
National Provider Identifier
1538947742
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-297645 Issued in FL
Practice address
3175 S Congress Ave Ste 203
Palm Springs, FL 33461-2562
Phone
(561) 298-2399
Fax
(561) 200-2319
NPI assigned
Sep 19, 2023
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 RBT-23-297645 FL Primary

Addresses

Primary practice location

3175 S Congress Ave Ste 203
Palm Springs, FL 33461-2562

Mailing address

2791 S Florida Mango Rd Apt 406
Lake Worth, FL 33461-2216
Phone (561) 719-2029

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
RBT-23-297645FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1538947742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2791 S FLORIDA MANGO RD APT 406",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334612216",
            "telephone_number": "561-719-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 S CONGRESS AVE STE 203",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612562",
            "telephone_number": "561-298-2399",
            "fax_number": "561-200-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESCO BALLADARES",
        "first_name": "ANIA",
        "middle_name": "ALICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-297645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.