Individual provider Active NPI

Jessica Alejandra Damian

  • Behavior Technician
  • Fremont, CA
National Provider Identifier
1902787609
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
44093 S Grimmer Blvd
Fremont, CA 94538-6382
Phone
(510) 284-7057
NPI assigned
Sep 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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 CA Primary

Addresses

Primary practice location

44093 S Grimmer Blvd
Fremont, CA 94538-6382

Mailing address

44093 S Grimmer Blvd
Fremont, CA 94538-6382
Phone (510) 284-7057

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

OrganizationSpecialtyStatusNew patients
ABA Shine LLC CurrentSince Sep 14, 2025 Accepting new patients

Locations

44093 S Grimmer Blvd
Fremont, CA 94538
Phone (510) 284-7057

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1902787609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44093 S GRIMMER BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945386382",
            "telephone_number": "510-284-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44093 S GRIMMER BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945386382",
            "telephone_number": "510-284-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIAN",
        "first_name": "JESSICA",
        "middle_name": "ALEJANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.