Individual provider Active NPI

Tom R Rafanan

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1932968989
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
24-326877 Issued in CA
Practice address
5075 Shoreham PL Ste 115
San Diego, CA 92122-5927
Phone
(858) 272-2662
NPI assigned
Mar 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 24-326877 CA Primary

Addresses

Primary practice location

5075 Shoreham PL Ste 115
San Diego, CA 92122-5927

Mailing address

5075 Shoreham PL Ste 115
San Diego, CA 92122-5927
Phone (858) 272-2662

Other names 1

  • Tom Clemen R Rafanan Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL gveracruz@ascaba.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

State licenses

LicenseStateTypeSpecialty
24-326877CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1932968989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 SHOREHAM PL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225927",
            "telephone_number": "858-272-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 SHOREHAM PL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225927",
            "telephone_number": "858-272-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFANAN",
        "first_name": "TOM",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "24-326877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "gveracruz@ascaba.com",
            "affiliation": "N",
            "endpointDescription": "Office Manager Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5075 Shoreham Pl Ste 115",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921225927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TOM CLEMEN",
            "last_name": "RAFANAN",
            "middle_name": "R",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.

Verify at the official NPI Registry.