Erika Raquel Fernandez, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

13121 Atlantic Blvd Ste 200
Jacksonville, FL 32225-0102

Phone

(904) 491-2111

Fax

(904) 512-0613

NPI assigned

Aug 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Erika Raquel Fernandez-Ugarte Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Proactive Life Skills LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1902331382
  NPD (past)

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1801407598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 ATLANTIC BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250102",
            "telephone_number": "904-491-2111",
            "fax_number": "904-512-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 ATLANTIC BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250102",
            "telephone_number": "904-491-2111",
            "fax_number": "904-512-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ERIKA",
        "middle_name": "RAQUEL",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL ANALYST CERTIFICATION BOARD",
            "identifier": "RBT-20-129930",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mike@proactivelifeskills.org",
            "affiliation": "N",
            "endpointDescription": "Secure Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13121 Atlantic Blvd Ste 200",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322250102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "FERNANDEZ-UGARTE",
            "middle_name": "RAQUEL",
            "credential": "RBT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alejandra Maria Fernandez, MA,CCC,SLP
• Andre Fernandez, PA-C
• Ciara Fernandez, LMHC
• Emma Roy Fernandez, PT
• Erica Fernandez
• Fernando Miguel Fernandez, D.O.
• Gabriel Eduardo Fernandez
• Gabriellea Elizabeth Zito Fernandez
• Giannia Fernandez
• Jessica Fernandez, BCBA

• Behavior Technician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.