Individual provider Active NPI

Siaka Nuah, BEHAVIOR TECHNICIAN

  • Behavior Technician
  • San Mateo, CA
National Provider Identifier
1962218933
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-225449 Issued in CA
Practice address
424 Peninsula Ave
San Mateo, CA 94401-1653
Phone
(650) 286-4396
NPI assigned
Dec 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 RBT-22-225449 CA Primary

Addresses

Primary practice location

424 Peninsula Ave
San Mateo, CA 94401-1653

Mailing address

1598 Ivy Hatch Way
Plumas Lake, CA 95961-8954
Phone (571) 492-1794

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
RBT-22-225449CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1962218933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 IVY HATCH WAY",
            "city": "PLUMAS LAKE",
            "state": "CA",
            "postal_code": "959618954",
            "telephone_number": "571-492-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 PENINSULA AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944011653",
            "telephone_number": "650-286-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUAH",
        "first_name": "SIAKA",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-22-225449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.