Active NPI
Porfiria Andrade Renteria
- Behavior Analyst
- Georgetown, TX
National Provider Identifier
1619549557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 120 Split Rein Dr
Georgetown, TX 78626-4110 - Phone
- (707) 624-5510
- NPI assigned
- Jul 12, 2021
- Last updated
- Jul 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | TX | Primary |
Addresses
Primary practice location
120 Split Rein Dr
Georgetown, TX 78626-4110
Mailing address
120 Split Rein Dr
Georgetown, TX 78626-4110
Phone (707) 624-5510
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": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1619549557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 SPLIT REIN DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786264110",
"telephone_number": "707-624-5510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SPLIT REIN DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786264110",
"telephone_number": "707-624-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENTERIA",
"first_name": "PORFIRIA",
"middle_name": "ANDRADE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.