Individual provider Active NPI

Yudisleivy Valdivia Jimenez

  • Behavior Technician
  • Greenacres, FL
National Provider Identifier
1962266429
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-325358 Issued in FL
Practice address
6801 Lake Worth Rd
Greenacres, FL 33467-2955
Phone
(616) 607-6675
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 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-24-325358 FL Primary

Addresses

Primary practice location

6801 Lake Worth Rd
Greenacres, FL 33467-2955

Mailing address

13801 NW 4TH St Apt 107
Pembroke Pines, FL 33028-2273
Phone (786) 714-7758

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-24-325358FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1962266429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 NW 4TH ST APT 107",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282273",
            "telephone_number": "786-714-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "616-607-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIA JIMENEZ",
        "first_name": "YUDISLEIVY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-325358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.