Individual provider Active NPI

Eduard Bryan B Florendo

  • Behavior Technician
  • Lake Elsinore, CA
National Provider Identifier
1558935494
Registry record updated May 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
803 Alpine CT
Lake Elsinore, CA 92530-1802
Phone
(949) 870-2749
NPI assigned
May 15, 2021
Last updated
May 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2021

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 Primary

Addresses

Primary practice location

803 Alpine CT
Lake Elsinore, CA 92530-1802

Mailing address

803 Alpine CT
Lake Elsinore, CA 92530-1802
Phone (949) 870-2749

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": "1621036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621036800000",
    "number": "1558935494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 ALPINE CT",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925301802",
            "telephone_number": "949-870-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 ALPINE CT",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925301802",
            "telephone_number": "949-870-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENDO",
        "first_name": "EDUARD BRYAN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-15",
        "last_updated": "2021-05-15",
        "certification_date": "2021-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.