Individual provider Active NPI

Heather J. Connelly

  • Behavior Technician
  • Fresno, CA
National Provider Identifier
1609016369
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
6177 N Thesta St Ste 103
Fresno, CA 93710
Phone
(559) 275-0559
NPI assigned
Feb 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary
Counselor 101Y00000X

Addresses

Primary practice location

6177 N Thesta St Ste 103
Fresno, CA 93710

Mailing address

16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (949) 833-2237

Other practice location 1

24863 W Jayne Ave
Coalinga, CA 93210-9502
Phone (559) 935-4900 ext. 6442

Other practice location 2

24863 W Jayne Ave
Coalinga, CA 93210-9502
Phone (559) 935-4900 ext. 6442

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": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1609016369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "949-833-2237",
            "fax_number": "559-692-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 N THESTA ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-275-0559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24863 W Jayne Ave",
            "address_purpose": "LOCATION",
            "city": "Coalinga",
            "state": "CA",
            "postal_code": "932109502",
            "country_code": "US",
            "telephone_number": "559-935-4900 x6442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24863 W Jayne Ave",
            "address_purpose": "LOCATION",
            "city": "Coalinga",
            "state": "CA",
            "postal_code": "932109502",
            "country_code": "US",
            "telephone_number": "559-935-4900 x6442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "HEATHER",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-20",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.

Verify at the official NPI Registry.