Individual provider Active NPI

Joel Thielen

  • Behavior Technician
  • Riverside, CA
National Provider Identifier
1780579508
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3516 Banbury Dr Apt 308
Riverside, CA 92505-1956
Phone
(209) 666-0346
NPI assigned
Jun 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 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 Primary

Addresses

Primary practice location

3516 Banbury Dr Apt 308
Riverside, CA 92505-1956

Mailing address

3516 Banbury Dr Apt 308
Riverside, CA 92505-1956
Phone (209) 666-0346

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": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1780579508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 BANBURY DR APT 308",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051956",
            "telephone_number": "209-666-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 BANBURY DR APT 308",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051956",
            "telephone_number": "209-666-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELEN",
        "first_name": "JOEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.