Individual provider Active NPI

Maria Fernanda Rubio Luque

  • Behavior Analyst
  • Garden Grove, CA
National Provider Identifier
1962056895
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
Y3890811 Issued in CA
Practice address
12399 Lewis St Ste 202
Garden Grove, CA 92840-4697
Phone
(714) 750-0575
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Y3890811 CA Primary

Addresses

Primary practice location

12399 Lewis St Ste 202
Garden Grove, CA 92840-4697

Mailing address

620 S Velare St Apt 306
Anaheim, CA 92804-7358
Phone (714) 561-2515

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
Y3890811CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1962056895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S VELARE ST APT 306",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928047358",
            "telephone_number": "714-561-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12399 LEWIS ST STE 202",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404697",
            "telephone_number": "714-750-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO LUQUE",
        "first_name": "MARIA",
        "middle_name": "FERNANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "Y3890811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.