Individual provider Active NPI

Brandon Matthew Cortez

  • Behavior Technician
  • Anaheim, CA
National Provider Identifier
1639677313
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
00002536 Issued in CA
Practice address
160 S Old Springs Rd
Anaheim, CA 92808-1260
Phone
(657) 202-6464
NPI assigned
Jan 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 00002536 CA Primary

Addresses

Primary practice location

160 S Old Springs Rd
Anaheim, CA 92808-1260

Mailing address

160 S Old Springs Rd
Anaheim, CA 92808-1260
Phone (657) 202-6464

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
00002536CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1639677313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S OLD SPRINGS RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081260",
            "telephone_number": "657-202-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S OLD SPRINGS RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081260",
            "telephone_number": "657-202-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "BRANDON",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "00002536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.