Active NPI
Braden Favero
- Behavior Technician
- Roy, UT
National Provider Identifier
1649706698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB346416
- Practice address
- 2563 W 5800 S
Roy, UT 84067-1334 - Phone
- (801) 991-0579
- NPI assigned
- May 11, 2017
- Sex
- Male
- 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 | BACB346416 | UT | Primary |
Addresses
Primary practice location
2563 W 5800 S
Roy, UT 84067-1334
Mailing address
2563 W 5800 S
Roy, UT 84067-1334
Phone (801) 991-0579
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB346416 | UT | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1649706698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2563 W 5800 S",
"city": "ROY",
"state": "UT",
"postal_code": "840671334",
"telephone_number": "801-991-0579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2563 W 5800 S",
"city": "ROY",
"state": "UT",
"postal_code": "840671334",
"telephone_number": "801-991-0579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAVERO",
"first_name": "BRADEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-11",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "UT",
"license": "BACB346416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.