Active NPI
Laryssa Ikehara
- Behavior Technician
- Tempe, AZ
National Provider Identifier
1902554736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 909 W Grove Pkwy Apt 2029
Tempe, AZ 85283-8422 - Phone
- (775) 287-9463
- NPI assigned
- Mar 10, 2022
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
909 W Grove Pkwy Apt 2029
Tempe, AZ 85283-8422
Mailing address
909 W Grove Pkwy Apt 2029
Tempe, AZ 85283-8422
Phone (775) 287-9463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000 | Other | NONE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | seguaroblossom@gmail.com | Direct |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seguaro Blossom LLC | Current | Accepting new patients | |
| Blooming Desert Prickly LLC | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tempe, AZ
- NPI 1114667987
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tempe, AZ
- NPI 1710635545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648598400000",
"number": "1902554736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 W GROVE PKWY APT 2029",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852838422",
"telephone_number": "775-287-9463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 W GROVE PKWY APT 2029",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852838422",
"telephone_number": "775-287-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKEHARA",
"first_name": "LARYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-10",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "0000000000",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "seguaroblossom@gmail.com",
"affiliation": "N",
"endpointDescription": "company email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "909 W Grove Pkwy Apt 2029",
"city": "Tempe",
"state": "AZ",
"country_code": "US",
"postal_code": "852838422",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.