Individual provider Active NPI

Jennifer Pasqualini

  • Behavior Analyst
  • Portland, OR
National Provider Identifier
1831662394
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
ABA-B-10241380 Issued in OR
Practice address
1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102
Phone
(510) 679-3545
NPI assigned
Jan 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X ABA-AB-10231714 OR
Behavior Technician 106S00000X
Behavior Analyst 103K00000X ABA-B-10241380 OR Primary

Addresses

Primary practice location

1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102

Mailing address

1675 SW Marlow Ave Ste 200
Portland, OR 97225-5102

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
ABA-B-10241380ORMDBehavioral Analyst
ABA-AB-10231714ORMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1831662394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255102",
            "telephone_number": "510-679-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUALINI",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "OR",
            "license": "ABA-AB-10231714",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "ABA-B-10241380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.

Verify at the official NPI Registry.