Active NPI
Josefa Vissia Patron
- Behavior Technician
- San Bruno, CA
National Provider Identifier
1861966038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 751 Camino PLZ Ste a
San Bruno, CA 94066-3401 - Phone
- (650) 637-8045
- NPI assigned
- Jan 21, 2019
- 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 | Primary |
Addresses
Primary practice location
751 Camino PLZ Ste a
San Bruno, CA 94066-3401
Mailing address
43 Blossom CT
Daly City, CA 94014-2116
Phone (209) 613-9102
Other practice location 1
43 Blossom Ct
Daly City, CA 94014-2116
Phone (209) 613-9102
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": "1548028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548028800000",
"number": "1861966038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 BLOSSOM CT",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940142116",
"telephone_number": "209-613-9102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 CAMINO PLZ STE A",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940663401",
"telephone_number": "650-637-8045"
}
],
"practiceLocations": [
{
"address_1": "43 Blossom Ct",
"address_purpose": "LOCATION",
"city": "Daly City",
"state": "CA",
"postal_code": "940142116",
"country_code": "US",
"telephone_number": "209-613-9102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATRON",
"first_name": "JOSEFA",
"middle_name": "VISSIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-21",
"last_updated": "2019-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.