Active NPI
Isis Marie Garcia Diaz
- Behavior Technician
- Lynnwood, WA
National Provider Identifier
1861151185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 61172291
- Practice address
- 4100 194TH St SW Ste 100
Lynnwood, WA 98036-4613 - Phone
- (423) 426-2761
- NPI assigned
- Dec 14, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 61172291 | WA | Primary |
Addresses
Primary practice location
4100 194TH St SW Ste 100
Lynnwood, WA 98036-4613
Mailing address
21600 Oxford St
Ste 1800
Woodland Hills, CA 91367
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 |
|---|---|---|---|
| 61172291 | WA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1861151185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21600 OXFORD ST",
"address_2": "STE 1800",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "91367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 194TH ST SW STE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364613",
"telephone_number": "423-426-2761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA DIAZ",
"first_name": "ISIS",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-14",
"last_updated": "2021-12-14",
"certification_date": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "61172291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.