Danielle Dominique Fastabend, CBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB0974695 Issued in WA

Practice address

9414 NE Fourth Plain Blvd
Vancouver, WA 98662-6109

Phone

(360) 892-5142

NPI assigned

Jul 22, 2019

Last updated

Jul 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1659924363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SE GRACE AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986048634",
            "telephone_number": "360-553-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9414 NE FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626109",
            "telephone_number": "360-892-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASTABEND",
        "first_name": "DANIELLE",
        "middle_name": "DOMINIQUE",
        "credential": "CBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB0974695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Sanford Farrellly, MS, CRC
• Cody Gene Farris
• Courtney Ann Farris, CADCI, SUDPT
• Adeyemi Fashola
• Robert Fasman, PH.D.
• Debbie Lee Fastenow, PTA
• Arash Fatemi, DC
• Anika Fatouros
• Destiny C Faulconer
• Gideon Lee Faulconer

• Behavior Technician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.