Active NPI
Heaven Abraham
- Behavior Technician
- Victorville, CA
National Provider Identifier
1740818160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 13090 Sundown Rd
Victorville, CA 92392-8873 - Phone
- (909) 435-6518
- NPI assigned
- Mar 31, 2020
- Last updated
- Jul 28, 2020
- 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 | Primary |
Addresses
Primary practice location
13090 Sundown Rd
Victorville, CA 92392-8873
Mailing address
13864 Jackson St
Oak Hills, CA 92344-7002
Phone (909) 246-5757
Other practice location 1
17595 Almahurst St
City Of Industry, CA 91748-1779
Phone (626) 344-4434
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595894400000",
"number": "1740818160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13864 JACKSON ST",
"city": "OAK HILLS",
"state": "CA",
"postal_code": "923447002",
"telephone_number": "909-246-5757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13090 SUNDOWN RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928873",
"telephone_number": "909-435-6518"
}
],
"practiceLocations": [
{
"address_1": "17595 Almahurst St",
"address_purpose": "LOCATION",
"city": "City Of Industry",
"state": "CA",
"postal_code": "917481779",
"country_code": "US",
"telephone_number": "626-344-4434",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABRAHAM",
"first_name": "HEAVEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2020-07-28",
"certification_date": "2020-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.