Individual provider Active NPI

Sierra Angelique Paul

  • Behavior Technician
  • Chula Vista, CA
National Provider Identifier
1629585096
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-16-22540 Issued in CA
Practice address
1346 Nicolette Ave
Chula Vista, CA 91913-3978
Phone
(619) 913-6160
NPI assigned
Jan 6, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 RBT-16-22540 CA Primary

Addresses

Primary practice location

1346 Nicolette Ave
Chula Vista, CA 91913-3978

Mailing address

5034 Palin St
San Diego, CA 92113-3524

Other practice location 1

4122 Bannock Ave
San Diego, CA 92117-2805
Phone (619) 913-6160

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
RBT-16-22540CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1515196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629585096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5034 PALIN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921133524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 NICOLETTE AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919133978",
            "telephone_number": "619-913-6160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4122 Bannock Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921172805",
            "country_code": "US",
            "telephone_number": "619-913-6160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUL",
        "first_name": "SIERRA",
        "middle_name": "ANGELIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-16-22540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.