Active NPI
Tricia Rose Callicoat, M.S., RBT
- Behavior Technician
- Lakeside, CA
National Provider Identifier
1679059877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-16-20493
- Practice address
- 9184 Manajo Rd
Lakeside, CA 92040-5065 - Phone
- (619) 756-4858
- NPI assigned
- Jul 11, 2018
- Last updated
- Jul 11, 2018
- 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 | RBT-16-20493 | CA | Primary |
Addresses
Primary practice location
9184 Manajo Rd
Lakeside, CA 92040-5065
Mailing address
9184 Manajo Rd
Lakeside, CA 92040-5065
Phone (619) 756-4858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14282354 | Other | CA | CAQH |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-16-20493 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531267200000",
"number": "1679059877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9184 MANAJO RD",
"city": "LAKESIDE",
"state": "CA",
"postal_code": "920405065",
"telephone_number": "619-756-4858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9184 MANAJO RD",
"city": "LAKESIDE",
"state": "CA",
"postal_code": "920405065",
"telephone_number": "619-756-4858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLICOAT",
"first_name": "TRICIA",
"middle_name": "ROSE",
"credential": "M.S., RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-11",
"last_updated": "2018-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-16-20493",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "14282354",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.