Active NPI
Jessica Reyes, BA / RBT
- Other Technician
- Stockton, CA
National Provider Identifier
1730742180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 5641 Saint Andrews Dr
Stockton, CA 95219-1928 - Phone
- (209) 559-0861
- NPI assigned
- Apr 20, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
5641 Saint Andrews Dr
Stockton, CA 95219-1928
Mailing address
1514 Maniago Dr
Stockton, CA 95206-3883
Phone (209) 559-0861
Other practice location 1
1381 Pajaro Ave
Manteca, CA 95336-2706
Phone (209) 559-0861
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 Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555718400000",
"number": "1730742180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 MANIAGO DR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952063883",
"telephone_number": "209-559-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5641 SAINT ANDREWS DR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952191928",
"telephone_number": "209-559-0861"
}
],
"practiceLocations": [
{
"address_1": "1381 Pajaro Ave",
"address_purpose": "LOCATION",
"city": "Manteca",
"state": "CA",
"postal_code": "953362706",
"country_code": "US",
"telephone_number": "209-559-0861",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYES",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"credential": "BA / RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-20",
"last_updated": "2019-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.