Active NPI
Karen Chestnut
- Behavior Technician
- Brea, CA
National Provider Identifier
1669931630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3230 E Imperial Hwy Ste 203
Brea, CA 92821-1706 - Phone
- (657) 444-9002
- NPI assigned
- Mar 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
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
3230 E Imperial Hwy Ste 203
Brea, CA 92821-1706
Mailing address
120 Terraza San Carlos
La Habra, CA 90631-7651
Phone (714) 313-9084
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W214941653-03 | Other | CA | AETNA |
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": "1552867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552867200000",
"number": "1669931630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 TERRAZA SAN CARLOS",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906317651",
"telephone_number": "714-313-9084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3230 E IMPERIAL HWY STE 203",
"city": "BREA",
"state": "CA",
"postal_code": "928211706",
"telephone_number": "657-444-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHESTNUT",
"first_name": "KAREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-18",
"last_updated": "2019-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "W214941653-03",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.