Individual provider Active NPI

Jacqueline Mendiola Garcia

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1578297933
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5075 Shoreham PL Ste 115
San Diego, CA 92122-5927
Phone
(858) 272-2662
Fax
(858) 272-2661
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

5075 Shoreham PL Ste 115
San Diego, CA 92122-5927

Mailing address

1515 W Arrow Hwy SPC 88
Upland, CA 91786-5032
Phone (909) 524-8311

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL gveracruz@ascaba.com Direct

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1578297933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W ARROW HWY SPC 88",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865032",
            "telephone_number": "909-524-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 SHOREHAM PL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225927",
            "telephone_number": "858-272-2662",
            "fax_number": "858-272-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA GARCIA",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "gveracruz@ascaba.com",
            "affiliation": "N",
            "endpointDescription": "Office Manager Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5075 Shoreham Pl Ste 115",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921225927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.