Individual provider Active NPI

Stephanie Soo Alynne Soo

  • Behavior Technician
  • Denver, CO
National Provider Identifier
1902579733
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
12015 E 46TH Ave Ste 680
Denver, CO 80239-3158
Phone
(303) 945-7063
Fax
(855) 568-2494
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 CO Primary

Addresses

Primary practice location

12015 E 46TH Ave Ste 680
Denver, CO 80239-3158

Mailing address

18726 S Western Ave
Gardena, CA 90248-3813
Phone (310) 856-0800

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

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1902579733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483813",
            "telephone_number": "310-856-0800",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12015 E 46TH AVE STE 680",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802393158",
            "telephone_number": "303-945-7063",
            "fax_number": "855-568-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOO",
        "first_name": "STEPHANIE SOO",
        "middle_name": "ALYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.