Active NPI
Jovita Maria Balderas
- Student in an Organized Health Care Education/Training Program
- Portland, OR
National Provider Identifier
1790577260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5415 SW Westgate Dr
Portland, OR 97221-2409 - Phone
- (999) 999-9999
- NPI assigned
- May 20, 2025
- Last updated
- Jun 26, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OR | Primary | |
| Behavior Technician | 106S00000X | IN-10249359 | OR |
Addresses
Primary practice location
5415 SW Westgate Dr
Portland, OR 97221-2409
Mailing address
5415 SW Westgate Dr
Portland, OR 97221-2409
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 |
|---|---|---|---|
| IN-10249359 | OR | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1790577260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 SW WESTGATE DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5415 SW WESTGATE DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212409",
"telephone_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDERAS",
"first_name": "JOVITA",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-20",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OR",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OR",
"license": "IN-10249359",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.