Gabriel Cossio Cedano

Key facts

NPI

1699545376

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

713 W Commonwealth Ave Ste C
Fullerton, CA 92832-1612

Phone

(714) 879-4274

Fax

(714) 879-2274

NPI assigned

Jan 4, 2024

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 4, 2024.

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1699545376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 W COMMONWEALTH AVE STE C",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321612",
            "telephone_number": "713-879-4274",
            "fax_number": "714-879-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W COMMONWEALTH AVE STE C",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321612",
            "telephone_number": "714-879-4274",
            "fax_number": "714-879-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSSIO CEDANO",
        "first_name": "GABRIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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