Active NPI
Taylor Rayne Sudol
- Behavior Technician
- Monrovia, CA
National Provider Identifier
1811645104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406 - Phone
- (760) 220-5255
- NPI assigned
- Mar 15, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | CA | Primary |
Addresses
Primary practice location
612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406
Mailing address
9975 SVL Box
Victorville, CA 92395-5145
Phone (760) 220-5255
Other practice location 1
13425 Spring Valley Pkwy
Victorville, CA 92395
Phone (760) 220-5255
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/A | Other |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647302400000",
"number": "1811645104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9975 SVL BOX",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923955145",
"telephone_number": "760-220-5255"
},
{
"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": "910163406",
"telephone_number": "760-220-5255"
}
],
"practiceLocations": [
{
"address_1": "13425 Spring Valley Pkwy",
"address_purpose": "LOCATION",
"city": "Victorville",
"state": "CA",
"postal_code": "92395",
"country_code": "US",
"telephone_number": "760-220-5255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUDOL",
"first_name": "TAYLOR",
"middle_name": "RAYNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-15",
"last_updated": "2022-03-15",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "N/A",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "612 S Myrtle Ave Ste 100",
"city": "Monrovia",
"state": "CA",
"country_code": "US",
"postal_code": "910163406",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.