Samantha Lauren Wickoff, RBT-18-65463

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-18-65463 Issued in CA

Practice address

612 S Myrtle Ave Ste 100
Monrovia, CA 91016

Phone

(626) 775-7888

NPI assigned

Nov 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1790254605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S MYRTLE AVE STE 100",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163406",
            "telephone_number": "626-775-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S MYRTLE AVE STE 100",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "91016",
            "telephone_number": "626-775-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Mall Ring Cir Ste 215",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890146691",
            "country_code": "US",
            "telephone_number": "702-547-6971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKOFF",
        "first_name": "SAMANTHA",
        "middle_name": "LAUREN",
        "credential": "RBT-18-65463",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-65463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Wicher, N.D.
• Lev Wicked
• Brooklyn Renee Wicker
• Zhanette Wickerd
• Michelle Wickland
• Christopher Wicks
• Keyarra Widamen
• Allen Widdison
• Abby Widener
• Amberlyn Widener

• Behavior Technician in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.