Active NPI
Jacob Parra
- Behavior Analyst
- Fresno, CA
National Provider Identifier
1790253680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-69501
- Practice address
- 530 E Herndon Ave Ste 105
Fresno, CA 93720-2990 - Phone
- (559) 275-0559
- NPI assigned
- Nov 8, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-23-69501 | Primary | |
| Behavior Technician | 106S00000X | RBT-18-68371 | CA |
Addresses
Primary practice location
530 E Herndon Ave Ste 105
Fresno, CA 93720-2990
Mailing address
PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123
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-18-68371 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1790253680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33568",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921633568",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E HERNDON AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202990",
"telephone_number": "559-275-0559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARRA",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-08",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-23-69501",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-18-68371",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.