MR. KEN WAGNER (NPI# 1538718523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538718523 |
| Entity Type | Individual |
| Full Name | MR. KEN WAGNER |
| Practice Address |
5729 S 1st Ave Tucson AZ 85706-4408 |
| Mailing Address |
4660w. El Camino Cerro Tucson AZ 85745 |
| Practice Telephone | 5204098507 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-09-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BEHAVOIRAL HEALTH | 522501 | 01 | |
| AZ | 522501 | 05 |
| Street Address |
5729 S 1ST AVE |
| City | TUCSON |
| State | AZ |
| Zip Code | 85706-4408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326527698 | Jessica Marie Rivera | Occupational Therapy Assistant | Sunnyside Unified School District No. 12, 2238 E. Ginter Road, Tuson, AZ 85706 | 2018-08-08 |
| 1902249865 | Shelley Mae Lopez | Licensed Practical Nurse | 2235 E. Ginter Road, Sunnyside Unified School District No. 12, Tucson, AZ 85706 | 2013-04-10 |
| 1689990707 | Rhonda Rene Kendall | Registered Nurse | 2238 E. Ginter Rd, Sunnyside Unified School Districkt No 12, Tucson, AZ 85706 | 2010-04-14 |
| 1124262365 | David E Kohler-edwards | Military Health Care Provider | 1670 E. Perimeter Way, 162nd Medical Group/arizona Air National Guard, Tucson, AZ 85706 | 2009-04-30 |
| 1225205271 | Silvia Garcia | Counselor | 6420 S. Wilmot Street, Suite B301, Tucson, AZ 85706 | 2008-05-09 |
| 1417131426 | Brian Reasoner | Nurse Practitioner | 5369 S. Calle Santa Cruz, Suite 145 Nextcare Urgent Care, Tucson, AZ 85706 | 2007-12-27 |
| 1528278546 | First Script Network Services, Inc. | Durable Medical Equipment & Medical Supplies | 3535 E Valencia Rd, Tucson, AZ 85706 | 2007-05-22 |
| 1245447283 | Kari B Bush | Pharmacist | 3675 E Britannia, Tucson, AZ 85706 | 2007-05-17 |
| 1063634681 | Tara Weber | Speech-Language Pathologist | 1132 12th Street, Douglas, AZ 85706 | 2007-05-03 |
| 1043331028 | Sharlyn Kay Deombeleg | Technician | 5956 S Pacacho El Diablo, Tucson, AZ 85706 | 2007-04-03 |
| Find all providers in zip 85706 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809215 | Kayli Riesgo | Behavior Technician | 5656 E Grant Rd Ste 200, Tucson, AZ 85712-2210 | 2020-10-19 |
| 1205447653 | Anna Josephine Lessner | Behavior Technician | 4050 W Aerie Dr Unit 71, Tucson, AZ 85741-2223 | 2020-08-10 |
| 1932719424 | Allison Marques | Behavior Technician | 11710 E Golf Links Rd, Tucson, AZ 85730-5612 | 2020-08-09 |
| 1992314207 | Michael Kelly Haskins | Behavior Technician | 11485 W Massingale Rd, Tucson, AZ 85743-9404 | 2020-07-23 |
| 1235752080 | Morgan S Turner | Behavior Technician | 1030 N Camino Miramonte Apt 3, Tucson, AZ 85716-4205 | 2020-05-27 |
| 1699398255 | Kristina Marie Kiss | Behavior Technician | 7401 E Speedway Blvd Apt 21204, Tucson, AZ 85710-1594 | 2020-05-18 |
| 1891314811 | Austin Cromer | Behavior Technician | 5701 E Glenn St Apt 93, Tucson, AZ 85712-5223 | 2020-04-09 |
| 1720618721 | Jacqueline Marie Ciufo | Behavior Technician | 1200 N El Dorado Pl Ste 700, Tucson, AZ 85715-4670 | 2020-01-19 |
| 1881246767 | Heather Monique Dutton | Behavior Technician | 1 S Church Ave Ste 200, Tucson, AZ 85701-1620 | 2019-07-11 |
| 1578122743 | Jacob Preston Jarvis | Behavior Technician | 3496 N Paseo De San Agustin, Tucson, AZ 85712-6035 | 2019-06-11 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.