Individual provider Active NPI

Eliza Brittany Ismerio

  • Behavior Technician
  • Rancho Cucamonga, CA
National Provider Identifier
1619703584
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708
Phone
(909) 353-7547
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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
Behavior Technician 106S00000X CA Primary

Addresses

Primary practice location

11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708

Mailing address

33496 Miners Dr
Yucaipa, CA 92399-6951
Phone (909) 838-0376

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": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1619703584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33496 MINERS DR",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923996951",
            "telephone_number": "909-838-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11799 SEBASTIAN WAY STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300708",
            "telephone_number": "909-353-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMERIO",
        "first_name": "ELIZA",
        "middle_name": "BRITTANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.