Maya Royce

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BH4985 Issued in AZ

Practice address

3744 Martingale Dr
Kingman, AZ 86409-2994

Phone

(928) 255-1747

NPI assigned

Sep 27, 2016

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Exclusive Certified Residential Care, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Kingman, AZ
  • NPI 1629528716
  NPD (past) Authorized official

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1639628936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33105 N 23RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850855088",
            "telephone_number": "623-285-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 MARTINGALE DR",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092994",
            "telephone_number": "928-255-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYCE",
        "first_name": "MAYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AZ",
            "license": "BH4985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Roth
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• Anthony Edmond Rowden, NP
• Bradley Norman Rowden, NP-C
• Andrew Conrad Rucker
• Tiffany E Russell, MD
• S Ismail Bokhari, M.D., P.C.
• S Ismail Bokhari, M.D., P.C.
• S Ismail Bokhari, M.D., P.C.

• All providers in Kingman, AZ
• Behavior Technician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.