Active NPI
Evelyn Ibanez
- Behavior Analyst
- Newark, CA
National Provider Identifier
1942788971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 35201 Lido Blvd
Newark, CA 94560 - Phone
- (650) 921-3664
- NPI assigned
- Aug 1, 2018
- 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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
35201 Lido Blvd
Newark, CA 94560
Mailing address
35201 Lido Blvd
Newark, CA 94560-1117
Phone (650) 921-3664
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": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1942788971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35201 LIDO BLVD",
"city": "NEWARK",
"state": "CA",
"postal_code": "945601117",
"telephone_number": "650-921-3664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35201 LIDO BLVD",
"city": "NEWARK",
"state": "CA",
"postal_code": "94560",
"telephone_number": "650-921-3664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBANEZ",
"first_name": "EVELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-01",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.