Active NPI
Enrique Estrada
- Behavior Analyst
- Riverside, CA
National Provider Identifier
1548934862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 6117 Brockton Ave Ste 105
Riverside, CA 92506-2282 - Phone
- (951) 440-6220
- NPI assigned
- Aug 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
6117 Brockton Ave Ste 105
Riverside, CA 92506-2282
Mailing address
81820 Shadow Palm Ave Apt 88
Indio, CA 92201-4021
Phone (720) 651-3659
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": "1627862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627862400000",
"number": "1548934862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81820 SHADOW PALM AVE APT 88",
"city": "INDIO",
"state": "CA",
"postal_code": "922014021",
"telephone_number": "720-651-3659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6117 BROCKTON AVE STE 105",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062282",
"telephone_number": "951-440-6220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "ENRIQUE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-02",
"last_updated": "2021-08-02",
"certification_date": "2021-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.