Active NPI
Jacquelyn Michelle Raez
- Behavior Technician
- Irvine, CA
National Provider Identifier
1649149626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 16 Technology Dr Ste 139
Irvine, CA 92618-2324 - Phone
- (949) 385-1656
- NPI assigned
- Oct 30, 2025
- Last updated
- May 28, 2026
- Sex
- Unspecified or another gender identity
- 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
16 Technology Dr Ste 139
Irvine, CA 92618-2324
Mailing address
25992 Dundee Dr
Lake Forest, CA 92630-8019
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Co-Creative Center LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Irvine, CA
- NPI 1104591239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1649149626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25992 DUNDEE DR",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926308019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 TECHNOLOGY DR STE 139",
"city": "IRVINE",
"state": "CA",
"postal_code": "926182324",
"telephone_number": "949-385-1656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAEZ",
"first_name": "JACQUELYN",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-10-30",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.