Individual provider Active NPI

Denver Brendan-Carter Baer

  • Behavior Technician
  • San Marcos, CA
National Provider Identifier
1659839991
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
19-79256 Issued in CA
Practice address
910 W San Marcos Blvd Ste 104
San Marcos, CA 92078-1116
Phone
(562) 810-3295
NPI assigned
Mar 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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 19-79256 CA Primary

Addresses

Primary practice location

910 W San Marcos Blvd Ste 104
San Marcos, CA 92078-1116

Mailing address

4710 Norma Dr
San Diego, CA 92115-3136
Phone (843) 499-3821

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
19-79256CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Creating a Positive Environment, Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1659839991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 NORMA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153136",
            "telephone_number": "843-499-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 W SAN MARCOS BLVD STE 104",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781116",
            "telephone_number": "562-810-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAER",
        "first_name": "DENVER",
        "middle_name": "BRENDAN-CARTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "19-79256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.