Josefa Nazareth Izaola-Jovel

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

R728-103-171-317 Issued in MN

Practice address

721 Commerce Dr
Woodbury, MN 55125-9118

Phone

(651) 414-4000

NPI assigned

Nov 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD
• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1710644547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9580 HUDSON BLVD N UNIT 107",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550424498",
            "telephone_number": "651-428-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 COMMERCE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259118",
            "telephone_number": "651-414-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZAOLA-JOVEL",
        "first_name": "JOSEFA",
        "middle_name": "NAZARETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": "R728-103-171-317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "josefa.izaola@fraser.org",
            "affiliation": "N",
            "address_1": "9580 Hudson Blvd N Unit 107",
            "city": "Lake Elmo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550424498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adrienne M Irmiter, PA-C
• Ryan Lawrence Isaacson, O.D.
• Island Therapeutic Massage
• Linda Kay Iten
• Jennifer Ann Itskovich, MSW
• Jack M Bert MD PA
• Catherine Jackson
• Heather Jackson, OD
• Latasha Cherelle Jackson
• Shantara Alexandria Jackson

• Behavior Technician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.