Active NPI
Rena Mixon
- Behavior Analyst
- San Diego, CA
National Provider Identifier
1821571910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-50903
- Practice address
- 4025 Camino del Rio S Ste 101
San Diego, CA 92108-4100 - Phone
- (855) 295-3276
- Fax
- (888) 588-2752
- NPI assigned
- Sep 13, 2018
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 1-21-50903 | CA | Primary |
Addresses
Primary practice location
4025 Camino del Rio S Ste 101
San Diego, CA 92108-4100
Mailing address
1333 S Mayflower Ave Ste 220
Monrovia, CA 91016-5239
Phone (818) 241-6780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-21-50903 | Other | CA | BOARD CERTIFIED BEHAVIOR ANALYST (BCBA) |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McGrew Behavioral Health Services, Inc. | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- American Canyon, CA
- NPI 1689191595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1821571910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1333 S MAYFLOWER AVE STE 220",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910165239",
"telephone_number": "818-241-6780",
"fax_number": "888-588-2752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 CAMINO DEL RIO S STE 101",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084100",
"telephone_number": "855-295-3276",
"fax_number": "888-588-2752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIXON",
"first_name": "RENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-13",
"last_updated": "2024-07-31",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-21-50903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD CERTIFIED BEHAVIOR ANALYST (BCBA)",
"identifier": "1-21-50903",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.