Active NPI
Derek Sierra, RBT
- Behavior Technician
- San Diego, CA
National Provider Identifier
1770331027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-346463
- Practice address
- 11650 Iberia PL Ste 130
San Diego, CA 92128-2431 - Phone
- (858) 264-5858
- NPI assigned
- May 10, 2024
- Sex
- Male
- 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 | RBT-24-346463 | CA | Primary |
Addresses
Primary practice location
11650 Iberia PL Ste 130
San Diego, CA 92128-2431
Mailing address
1274 Center Court Dr Ste 211
Covina, CA 91724-3668
Phone (626) 339-4999
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-346463 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1770331027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1274 CENTER COURT DR STE 211",
"city": "COVINA",
"state": "CA",
"postal_code": "917243668",
"telephone_number": "626-339-4999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11650 IBERIA PL STE 130",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282431",
"telephone_number": "858-264-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIERRA",
"first_name": "DEREK",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-10",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-24-346463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.