Individual provider Active NPI

Wendy Lazara De la Cruz Felipe

  • Behavior Technician
  • Jacksonville, FL
National Provider Identifier
1720971047
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB1274743 Issued in FL
Practice address
5885 Edenfield Rd Apt K27
Jacksonville, FL 32277-1247
Phone
(904) 413-6589
Fax
(904) 413-6589
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X BACB1274743 FL Primary

Addresses

Primary practice location

5885 Edenfield Rd Apt K27
Jacksonville, FL 32277-1247

Mailing address

5885 Edenfield Rd Apt K27
Jacksonville, FL 32277-1247
Phone (904) 413-6589

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

LicenseStateTypeSpecialty
BACB1274743FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1720971047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 EDENFIELD RD APT K27",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771247",
            "telephone_number": "904-413-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 EDENFIELD RD APT K27",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771247",
            "telephone_number": "904-413-6589",
            "fax_number": "904-413-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ FELIPE",
        "first_name": "WENDY",
        "middle_name": "LAZARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "BACB1274743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.