Active NPI
Madisen Elyssa Aid
- Behavior Technician
- San Diego, CA
National Provider Identifier
1659969038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 11650 Iberia PL Ste 130
San Diego, CA 92128-2431 - Phone
- (800) 434-8923
- NPI assigned
- Jan 1, 2021
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
11650 Iberia PL Ste 130
San Diego, CA 92128-2431
Mailing address
3410 Taussig St
San Diego, CA 92124-3216
Phone (619) 830-7030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009846663-03 | Other | CA | TRICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | maid@abskids.com | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609459200000",
"number": "1659969038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3410 TAUSSIG ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921243216",
"telephone_number": "619-830-7030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11650 IBERIA PL STE 130",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282431",
"telephone_number": "800-434-8923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AID",
"first_name": "MADISEN",
"middle_name": "ELYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-01",
"last_updated": "2021-01-01",
"certification_date": "2021-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "009846663-03",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "maid@abskids.com",
"affiliation": "N",
"endpointDescription": "Work email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "11650 Iberia Pl Ste 130",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921282431",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 1, 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.