Individual provider Active NPI

Keiko Ushijima-Mwesigwa

  • Behavior Analyst
  • San Jose, CA
National Provider Identifier
1790300564
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB376567 Issued in CA
Practice address
631 River Oaks Pkwy
San Jose, CA 95134-1907
Phone
(408) 914-9153
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X
Behavior Technician 106S00000X RBT-17-36777 CA
Behavior Analyst 103K00000X BACB376567 CA Primary

Addresses

Primary practice location

631 River Oaks Pkwy
San Jose, CA 95134-1907

Mailing address

631 River Oaks Pkwy
San Jose, CA 95134-1907
Phone (408) 914-7478

Other practice location 1

55 River Oaks Pl Apt 354
San Jose, CA 95134-2071
Phone (818) 268-2166

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

LicenseStateTypeSpecialty
BACB376567CAMDBehavioral Analyst
RBT-17-36777CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1790300564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 RIVER OAKS PKWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341907",
            "telephone_number": "408-914-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 RIVER OAKS PKWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341907",
            "telephone_number": "408-914-9153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 River Oaks Pl Apt 354",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951342071",
            "country_code": "US",
            "telephone_number": "818-268-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "USHIJIMA-MWESIGWA",
        "first_name": "KEIKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-17-36777",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "BACB376567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.