Individual provider Active NPI

Jesse James Vang

  • Behavior Analyst
  • Fresno, CA
National Provider Identifier
1639688971
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
68-0434185 Issued in CA
Practice address
7339 N 1St St
Fresno, CA 93720-2954
Phone
(559) 666-2536
NPI assigned
Sep 28, 2017
Sex
Male
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 Analyst 103K00000X 68-0434185 CA Primary

Addresses

Primary practice location

7339 N 1St St
Fresno, CA 93720-2954

Mailing address

6400 Tupelo Dr
Citrus Heights, CA 95621-1741

Other practice location 1

6400 Tupelo Dr
Citrus Heights, CA 95621-1741
Phone (916) 729-3098

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
68-0434185CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639688971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 TUPELO DR",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7339 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202954",
            "telephone_number": "559-666-2536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Tupelo Dr",
            "address_purpose": "LOCATION",
            "city": "Citrus Heights",
            "state": "CA",
            "postal_code": "956211741",
            "country_code": "US",
            "telephone_number": "916-729-3098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANG",
        "first_name": "JESSE",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "68-0434185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, 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.