Individual provider Active NPI

Maria Edraisa Jevitzky

  • Behavior Analyst
  • Covina, CA
National Provider Identifier
1669199543
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-61855 Issued in CA
Practice address
1274 Center Court Dr Ste 211
Covina, CA 91724-3668
Phone
(619) 306-2646
NPI assigned
Oct 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-61855 CA Primary

Addresses

Primary practice location

1274 Center Court Dr Ste 211
Covina, CA 91724-3668

Mailing address

2760 W Peoria Ave # 1277
Phoenix, AZ 85029-5202
Phone (626) 339-4999

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": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1669199543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 W PEORIA AVE # 1277",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295202",
            "telephone_number": "626-339-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1274 CENTER COURT DR STE 211",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243668",
            "telephone_number": "619-306-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEVITZKY",
        "first_name": "MARIA",
        "middle_name": "EDRAISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-22-61855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.