Active NPI
Jessica Cordova
- Behavior Analyst
- Fair Lawn, NJ
National Provider Identifier
1558927657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-18-33798
- Practice address
- 39-05 Wenonah Dr
Fair Lawn, NJ 07410-5424 - Phone
- (201) 679-3126
- NPI assigned
- May 14, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-18-33798 | NJ | Primary |
Addresses
Primary practice location
39-05 Wenonah Dr
Fair Lawn, NJ 07410-5424
Mailing address
39-05 Wenonah Dr
Fair Lawn, NJ 07410-5424
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": "1557792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571270400000",
"number": "1558927657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39-05 WENONAH DR",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074105424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39-05 WENONAH DR",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074105424",
"telephone_number": "201-679-3126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-14",
"last_updated": "2019-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "1-18-33798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Lawn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.