Active NPI
Sandra Lustre
- Behavior Technician
- Gilroy, CA
National Provider Identifier
1841838752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1845 Pacheco Pass Hwy
Gilroy, CA 95020-9529 - Phone
- (408) 500-8046
- NPI assigned
- Dec 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | CA | Primary |
Addresses
Primary practice location
1845 Pacheco Pass Hwy
Gilroy, CA 95020-9529
Mailing address
1845 Pacheco Pass Hwy
Gilroy, CA 95020-9529
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46251587 | Medicaid | CA | |
| OPG462A51587 | Other | CA | INSURANCE CARD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Sandra.lustre@icloud.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1841838752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1845 PACHECO PASS HWY",
"city": "GILROY",
"state": "CA",
"postal_code": "950209529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 PACHECO PASS HWY",
"city": "GILROY",
"state": "CA",
"postal_code": "950209529",
"telephone_number": "408-500-8046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSTRE",
"first_name": "SANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-11",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46251587",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE CARD",
"identifier": "OPG462A51587",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Sandra.lustre@icloud.com",
"affiliation": "N",
"address_1": "1845 Pacheco Pass Hwy",
"city": "Gilroy",
"state": "CA",
"country_code": "US",
"postal_code": "950209529",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gilroy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.