Mandela Rayvon Brown

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

106S00000X Issued in CA

Practice address

1200 Concord Ave #100
Concord, CA 94520-4969

Phone

(855) 729-0478

NPI assigned

Jun 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1831828896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 WEXLER PEAK WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318338",
            "telephone_number": "925-344-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CONCORD AVE #100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204969",
            "telephone_number": "855-729-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MANDELA",
        "middle_name": "RAYVON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "106S00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMV",
            "identifier": "Y7082332",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Bernard Brown, D.D.S
• Hannah Jane Brown
• Kaitlyn I Brown
• Kenya Brown, AMFT
• Luis Kenyatta Brown
• Maya Brown
• Michael Deshaun Brown
• Nayeli Brown
• Robin Brown
• Sara Lynn Brown

• Behavior Technician in Concord, CA
• Providers in Concord, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.