Nicole Monique Azevedo, BCBA
Individual provider Active NPI Behavior Analyst · Milpitas, CA
NPI 1790171908 · NPPES record last updated Jan 12, 2023
Key facts
- NPI
- 1790171908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-15-18422 (CA)
- Practice address
- 1377 Coyote Creek Way
Milpitas, CA 95035-7944 - Phone
- (408) 728-5853
- NPI assigned
- Apr 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Love 2 Learn Therapies Inc | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-15-18422 | CA | Yes |
Addresses
Primary practice location
1377 Coyote Creek Way
Milpitas, CA 95035-7944
Mailing address
1377 Coyote Creek Way
Milpitas, CA 95035-7944
Phone (408) 728-5853
Other names
- Nicole Monique Rodrigues
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- Armando Bajacan Jr.
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- Sraboni S.B. Banerjee
All providers in Milpitas, CA · Behavior Analyst in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.