Active NPI
Jeevarima Soundaranayagam
- Behavior Analyst
- San Mateo, CA
National Provider Identifier
1881059285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- F7089390
- Practice address
- 424 Peninsula Ave
San Mateo, CA 94401-1653 - Phone
- (650) 286-4396
- NPI assigned
- Dec 29, 2015
- 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 Analyst | 103K00000X | F7089390 | CA | Primary |
Addresses
Primary practice location
424 Peninsula Ave
San Mateo, CA 94401-1653
Mailing address
39456 Parkhurst Dr
Fremont, CA 94538-2079
Phone (510) 509-0632
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 |
|---|---|---|---|
| F7089390 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1881059285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39456 PARKHURST DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382079",
"telephone_number": "510-509-0632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 PENINSULA AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011653",
"telephone_number": "650-286-4396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUNDARANAYAGAM",
"first_name": "JEEVARIMA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-29",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "F7089390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.