Active NPI
Tu V Truong
- Behavior Analyst
- Waterloo, IA
National Provider Identifier
1902385339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 123073
- Practice address
- 815 Tower Park Dr
Waterloo, IA 50701-9027 - Phone
- (319) 242-7642
- Fax
- (515) 957-3380
- NPI assigned
- Aug 7, 2018
- 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 Analyst | 103K00000X | 123073 | IA | Primary |
Addresses
Primary practice location
815 Tower Park Dr
Waterloo, IA 50701-9027
Mailing address
815 Tower Park Dr
Waterloo, IA 50701-9027
Phone (319) 242-7642
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 |
|---|---|---|---|
| 123073 | IA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715126400000",
"number": "1902385339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 TOWER PARK DR",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507019027",
"telephone_number": "319-242-7642",
"fax_number": "515-957-3380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 TOWER PARK DR",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507019027",
"telephone_number": "319-242-7642",
"fax_number": "515-957-3380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "TU",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-07",
"last_updated": "2024-05-08",
"certification_date": "2024-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IA",
"license": "123073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.