Individual provider Active NPI

Sheila Juan Santos

  • Behavior Analyst
  • Corona, CA
National Provider Identifier
1821506809
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-52701 Issued in CA
Practice address
1295 Corona Pointe CT Ste 102
Corona, CA 92879-1721
Phone
(855) 223-7123
NPI assigned
Jan 12, 2018
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-52701 CA Primary
Behavior Technician 106S00000X RBT-17-3573-56155 CA

Addresses

Primary practice location

1295 Corona Pointe CT Ste 102
Corona, CA 92879-1721

Mailing address

16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (855) 223-7123

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

LicenseStateTypeSpecialty
RBT-17-3573-56155CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1821506809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "855-223-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 CORONA POINTE CT STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791721",
            "telephone_number": "855-223-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAN SANTOS",
        "first_name": "SHEILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-21-52701",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-17-3573-56155",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.