Active NPI
Yanira Alexandra Cruz
- Behavior Technician
- Fairfax, VA
National Provider Identifier
1811767460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1019469
- Practice address
- 11130 Fairfax Blvd Ste 305
Fairfax, VA 22030-5035 - Phone
- (571) 918-9977
- Fax
- (571) 415-5459
- NPI assigned
- Jan 4, 2024
- 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 | BACB1019469 | MD | Primary |
Addresses
Primary practice location
11130 Fairfax Blvd Ste 305
Fairfax, VA 22030-5035
Mailing address
11130 Fairfax Blvd Ste 305
Fairfax, VA 22030-5035
Phone (571) 918-9977
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 |
|---|---|---|---|
| BACB1019469 | MD | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1811767460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11130 FAIRFAX BLVD STE 305",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220305035",
"telephone_number": "571-918-9977",
"fax_number": "571-415-5459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11130 FAIRFAX BLVD STE 305",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220305035",
"telephone_number": "571-918-9977",
"fax_number": "571-415-5459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "YANIRA",
"middle_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-04",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MD",
"license": "BACB1019469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.