Madison Diane Maltz

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

28643 Vista Madera
Rancho Palos Verdes, CA 90275-0869

Phone

(310) 292-7923

NPI assigned

Oct 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1689391047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23842 HAWTHORNE BLVD STE 100-101",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055929",
            "telephone_number": "310-292-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28643 VISTA MADERA",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750869",
            "telephone_number": "310-292-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTZ",
        "first_name": "MADISON",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "NA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.