Active NPI
Evelyn Denisse Cordova, REGISTERED BEHAVIOR
- Behavior Technician
- San Diego, CA
National Provider Identifier
1861085573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-297485
- Practice address
- 501 W Broadway Ste 800
San Diego, CA 92101-3546 - Phone
- (877) 418-2978
- NPI assigned
- Feb 12, 2021
- 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 | RBT-20-113368 | CA | |
| Behavior Technician | 106S00000X | RBT-23-297485 | CA | Primary |
Addresses
Primary practice location
501 W Broadway Ste 800
San Diego, CA 92101-3546
Mailing address
350 Fairway Dr Ste 101
Deerfield Beach, FL 33441-1834
Phone (877) 418-2978
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-113368 | CA | MD | Behavior Technician |
| RBT-23-297485 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748563200000",
"number": "1861085573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 FAIRWAY DR STE 101",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334411834",
"telephone_number": "877-418-2978",
"fax_number": "866-500-2186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W BROADWAY STE 800",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921013546",
"telephone_number": "877-418-2978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "EVELYN",
"middle_name": "DENISSE",
"credential": "REGISTERED BEHAVIOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-12",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-20-113368",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-23-297485",
"primary": true
}
],
"identifiers": [],
"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 May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.