Individual provider Active NPI

Nicole Cruz, M.S., B.C.B.A.,

  • Behavior Analyst
  • Rancho Cordova, CA
National Provider Identifier
1770905499
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-13466 Issued in CA
Practice address
3244 Prospect Park Dr
Rancho Cordova, CA 95670-6244
Phone
(916) 220-2921
NPI assigned
Jan 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-13466 CA Primary

Addresses

Primary practice location

3244 Prospect Park Dr
Rancho Cordova, CA 95670-6244

Mailing address

3244 Prospect Park Dr
Rancho Cordova, CA 95670-6244
Phone (916) 220-2921

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
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1770905499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 PROSPECT PARK DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706244",
            "telephone_number": "916-220-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 PROSPECT PARK DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706244",
            "telephone_number": "916-220-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "NICOLE",
        "credential": "M.S., B.C.B.A.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-13-13466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; 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.