Active NPI
Antonia Mann
- Behavior Technician
- Bremerton, WA
National Provider Identifier
1710493598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 60802307
- Practice address
- 6795 Skyview PL NW
Bremerton, WA 98311-8946 - Phone
- (877) 712-2735
- NPI assigned
- Dec 15, 2017
- Last updated
- Dec 15, 2017
- 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 | 60802307 | WA | Primary |
Addresses
Primary practice location
6795 Skyview PL NW
Bremerton, WA 98311-8946
Mailing address
7391 E Maple St
Port Orchard, WA 98366-8435
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60802307 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513296000000",
"number": "1710493598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7391 E MAPLE ST",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983668435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6795 SKYVIEW PL NW",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118946",
"telephone_number": "877-712-2735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "ANTONIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-15",
"last_updated": "2017-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "60802307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.