Active NPI
Ronaldy Jose Chacon-Diaz
- Behavior Technician
- Los Angeles, CA
National Provider Identifier
1881319580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- Y5167594
- Practice address
- 4322 Wilshire Blvd Ste 104
Los Angeles, CA 90010-3737 - Phone
- (323) 879-4951
- NPI assigned
- Oct 5, 2022
- Sex
- Male
- 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 | Y5167594 | CA | Primary |
Addresses
Primary practice location
4322 Wilshire Blvd Ste 104
Los Angeles, CA 90010-3737
Mailing address
1546 W 59TH St
Los Angeles, CA 90047-1211
Phone (323) 875-2337
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 |
|---|---|---|---|
| Y5167594 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1881319580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1546 W 59TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900471211",
"telephone_number": "323-875-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4322 WILSHIRE BLVD STE 104",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103737",
"telephone_number": "323-879-4951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACON-DIAZ",
"first_name": "RONALDY",
"middle_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "Y5167594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.