Active NPI
Matthew Cruz
- Behavior Technician
- Napa, CA
National Provider Identifier
1790458255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-233967
- Practice address
- 3419 Valle Verde Dr
Napa, CA 94558-2414 - Phone
- (707) 721-2060
- NPI assigned
- Jul 29, 2021
- Reactivated
- Dec 8, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 Technician | 106S00000X | |||
| Behavior Technician | 106S00000X | RBT-22-233967 | HI | Primary |
Addresses
Primary practice location
3419 Valle Verde Dr
Napa, CA 94558-2414
Mailing address
3419 Valle Verde Dr
Napa, CA 94558-2414
Phone (707) 721-2060
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-22-233967 | HI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670544000000",
"number": "1790458255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3419 VALLE VERDE DR",
"city": "NAPA",
"state": "CA",
"postal_code": "945582414",
"telephone_number": "707-721-2060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3419 VALLE VERDE DR",
"city": "NAPA",
"state": "CA",
"postal_code": "945582414",
"telephone_number": "707-721-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-29",
"last_updated": "2022-12-09",
"certification_date": "2022-12-09",
"deactivation_date": "2022-08-14",
"reactivation_date": "2022-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "HI",
"license": "RBT-22-233967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.