Nardeen Faddah

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

Y9005972 Issued in CA

Practice address

9191 Julie Beth St
Cypress, CA 90630-2638

Phone

(951) 522-5760

NPI assigned

Aug 20, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1609609353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 LEWIS ST STE 102",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404698",
            "telephone_number": "760-634-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 JULIE BETH ST",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906302638",
            "telephone_number": "951-522-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADDAH",
        "first_name": "NARDEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "Y9005972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Cypress, CA
• Providers in Cypress, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.