Active NPI
Chanece Bagsby
- Behavior Technician
- Hawthorne, CA
National Provider Identifier
1629895362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 23842 Hawthorne Boulevard
Suite 100 & 101
Hawthorne, CA 90503 - Phone
- (424) 999-2990
- NPI assigned
- Sep 24, 2024
- Last updated
- Sep 24, 2024
- 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 Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
23842 Hawthorne Boulevard
Suite 100 & 101
Hawthorne, CA 90503
Mailing address
11642 S Wilton PL
Los Angeles, CA 90047-5052
Phone (323) 516-5869
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": "1727136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1629895362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11642 S WILTON PL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900475052",
"telephone_number": "323-516-5869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23842 HAWTHORNE BOULEVARD",
"address_2": "SUITE 100 & 101",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "90503",
"telephone_number": "424-999-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGSBY",
"first_name": "CHANECE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.