Individual provider Active NPI

Amber Marie Weeden

  • Behavior Technician
  • Sacramento, CA
National Provider Identifier
1588171045
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
15-07365 Issued in CA
Practice address
1300 Ethan Way Ste 175
Sacramento, CA 95825-2277
Phone
(866) 523-4268
NPI assigned
Jan 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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 15-07365 CA Primary

Addresses

Primary practice location

1300 Ethan Way Ste 175
Sacramento, CA 95825-2277

Mailing address

PO Box 399381
San Francisco, CA 94139-9381
Phone (866) 523-4268

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
15-07365CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1588171045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399381",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941399381",
            "telephone_number": "866-523-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ETHAN WAY STE 175",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252277",
            "telephone_number": "866-523-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEDEN",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-05",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "15-07365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.