Individual provider Active NPI

Gabriela Vanessa Barragan

  • Behavior Technician
  • Monrovia, CA
National Provider Identifier
1891573721
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
W1288744 Issued in CA
Practice address
612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406
Phone
(180) 046-5320
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 W1288744 CA Primary

Addresses

Primary practice location

612 S Myrtle Ave Ste 100
Monrovia, CA 91016-3406

Mailing address

11777 Charwood Rd
Victorville, CA 92392-0416
Phone (909) 329-5434

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
W1288744CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1891573721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11777 CHARWOOD RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923920416",
            "telephone_number": "909-329-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S MYRTLE AVE STE 100",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163406",
            "telephone_number": "180-046-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRAGAN",
        "first_name": "GABRIELA",
        "middle_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "W1288744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.