Individual provider Active NPI

Elisa Serna

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1659039006
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB578194 Issued in CA
Practice address
2404 F St
San Diego, CA 92102-2025
Phone
(619) 455-2282
NPI assigned
Dec 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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 BACB578194 CA Primary

Addresses

Primary practice location

2404 F St
San Diego, CA 92102-2025

Mailing address

2404 F St
San Diego, CA 92102-2025
Phone (619) 455-2282

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
BACB578194CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1659039006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 F ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022025",
            "telephone_number": "619-455-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 F ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022025",
            "telephone_number": "619-455-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERNA",
        "first_name": "ELISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "BACB578194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.