Nicolas Kyle Del Mundo Petelo

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3704 N 35TH St
Tacoma, WA 98407-6033

Phone

(206) 580-6940

NPI assigned

Dec 19, 2022

Last updated

Dec 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1922710292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 E ROY ST APT 633",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981024601",
            "telephone_number": "510-432-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 N 35TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984076033",
            "telephone_number": "206-580-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETELO",
        "first_name": "NICOLAS KYLE",
        "middle_name": "DEL MUNDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perspectives Psychiatry
• John David Perz, MSW
• Karen L Perz, PT
• Heather Nicole Pesce, LMHCA, SUDP
• Jennifer Rodriguez Pete, LMHC
• Peter D. Gauger DDS PLLC (Tacoma Oral Surgery & Implants)
• Peter E. Krumins MD PS Inc
• H. Mignonne Peter, M.A. ABS
• Patricia Petermann, AUD
• Kimberly Peters-Poonkasem, LMP

• Behavior Technician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.

Verify at the official NPI Registry.