Active NPI
Laura Tatiana Reyes, BCBA
- Behavior Analyst
- Irvine, CA
National Provider Identifier
1972004224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-58682
- Practice address
- 106 Discovery
Irvine, CA 92618-3131 - Phone
- (949) 203-8872
- NPI assigned
- Feb 22, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 00004676 | CA | |
| Behavior Technician | 106S00000X | RBT-17-40994 | CA | |
| Behavior Analyst | 103K00000X | 1-22-58682 | CA | Primary |
Addresses
Primary practice location
106 Discovery
Irvine, CA 92618-3131
Mailing address
5850 Granite Pkwy Ste 600
Plano, TX 75024-6753
Phone (818) 345-2345
Other practice location 1
12399 Lewis St Ste 202
Garden Grove, CA 92840-4697
Phone (714) 750-0575
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00004676 | CA | MD | Behavior Technician |
| RBT-17-40994 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA Enhancement | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Huntington Beach, CA
- NPI 1003448804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651104000000",
"number": "1972004224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 GRANITE PKWY STE 600",
"city": "PLANO",
"state": "TX",
"postal_code": "750246753",
"telephone_number": "818-345-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 DISCOVERY",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183131",
"telephone_number": "949-203-8872"
}
],
"practiceLocations": [
{
"address_1": "12399 Lewis St Ste 202",
"address_purpose": "LOCATION",
"city": "Garden Grove",
"state": "CA",
"postal_code": "928404697",
"country_code": "US",
"telephone_number": "714-750-0575",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYES",
"first_name": "LAURA",
"middle_name": "TATIANA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2022-04-28",
"certification_date": "2022-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "00004676",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-17-40994",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-22-58682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.