Individual provider Active NPI

Vivian Vu

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1962146365
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB783298 Issued in CA
Practice address
2755 55TH St
San Diego, CA 92105-5043
Phone
(619) 493-0077
Fax
(619) 793-1986
NPI assigned
Apr 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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 BACB783298 CA Primary

Addresses

Primary practice location

2755 55TH St
San Diego, CA 92105-5043

Mailing address

3131 Cauby St Apt 75
San Diego, CA 92110-4611
Phone (858) 717-2104

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
BACB783298CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1962146365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 CAUBY ST APT 75",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104611",
            "telephone_number": "858-717-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 55TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055043",
            "telephone_number": "619-493-0077",
            "fax_number": "619-793-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "BACB783298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 22, 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.