Individual provider Active NPI

Annet De Las Mercedes Sanchez Santana II

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1871113225
Registry record updated Apr 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
2105614761 Issued in NV
Practice address
3090 Liberty Cir N
Las Vegas, NV 89121-1330
Phone
(702) 738-8136
NPI assigned
Apr 25, 2020
Last updated
Apr 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 2105614761 NV Primary

Addresses

Primary practice location

3090 Liberty Cir N
Las Vegas, NV 89121-1330

Mailing address

3090 Liberty Cir N
Las Vegas, NV 89121-1330
Phone (702) 738-8136

Other identifiers 2

IdentifierTypeStateIssuer
7027388136MedicaidNV
SSNMedicaidNV

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

LicenseStateTypeSpecialty
2105614761NVMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1587772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1871113225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 LIBERTY CIR N",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891211330",
            "telephone_number": "702-738-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 LIBERTY CIR N",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891211330",
            "telephone_number": "702-738-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ SANTANA",
        "first_name": "ANNET",
        "middle_name": "DE LAS MERCEDES",
        "name_prefix": "Mrs.",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-25",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "2105614761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7027388136",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SSN",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; 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.