Individual provider Active NPI

Alhasan Bassam, BT

  • Behavior Technician
  • Santee, CA
National Provider Identifier
1710619184
Registry record updated Jun 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
8761 Graves Ave Apt 18C
Santee, CA 92071-4614
Phone
(619) 219-1975
NPI assigned
Jun 25, 2022
Last updated
Jun 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Technician 106S00000X CA Primary

Addresses

Primary practice location

8761 Graves Ave Apt 18C
Santee, CA 92071-4614

Mailing address

8761 Graves Ave Apt 18C
Santee, CA 92071-4614
Phone (619) 219-1975

Other identifiers 1

IdentifierTypeStateIssuer
Y3404397OtherCAMAXIM HEALTH CARE

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
Bachelor of Theology

NPI Registry JSON

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656115200000",
    "number": "1710619184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8761 GRAVES AVE APT 18C",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920714614",
            "telephone_number": "619-219-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8761 GRAVES AVE APT 18C",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920714614",
            "telephone_number": "619-219-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSAM",
        "first_name": "ALHASAN",
        "credential": "BT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-25",
        "last_updated": "2022-06-25",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAXIM HEALTH CARE",
            "identifier": "Y3404397",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

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