ANNIE LYSARIS BUSTAMANTE (NPI# 1932744331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932744331 |
| Entity Type | Individual |
| Full Name | ANNIE LYSARIS BUSTAMANTE |
| Practice Address |
9027 Ferndale Ave Fontana CA 92335-6017 |
| Practice Telephone | 9093437779 |
| Mailing Telephone | 9093437779 |
| Enumeration Date | 2019-11-10 |
| Last Update Date | 2019-11-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
9027 FERNDALE AVE |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-6017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| 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 |
|---|---|---|---|---|
| 1174149454 | Jennifer Nathalie Sandoval-guzman | Behavior Technician | 7490 Concord Ave, Fontana, CA 92336-1707 | 2020-06-22 |
| 1235761172 | Legend Holman | Behavior Technician | 17750 Fairview Dr, Fontana, CA 92336-2864 | 2020-02-09 |
| 1073143277 | Danielle Deguzman | Behavior Technician | 13675 Alexander Ct, Fontana, CA 92336-3902 | 2020-01-16 |
| 1306481486 | Cynthia Duran | Behavior Technician | 17095 Hackberry Ln, Fontana, CA 92337-6885 | 2019-11-12 |
| 1528603156 | Kathia Banda | Behavior Technician | 11519 Oak Knoll Ct, Fontana, CA 92337-0138 | 2019-11-07 |
| 1104460013 | Aryana Natalie Cruz | Behavior Technician | 7802 Wasabi Way, Fontana, CA 92336-3122 | 2019-11-04 |
| 1235786120 | Briana Korinna Calderon | Behavior Technician | 11618 Belmonte Rd, Fontana, CA 92337-0908 | 2019-08-24 |
| 1194370726 | Johnny Murcia | Behavior Technician | 14222 Rideout Ct, Fontana, CA 92336-3605 | 2019-08-09 |
| 1376196352 | Kimberly June Hoekwater | Behavior Technician | 16340 Trelaney Rd, Fontana, CA 92337-0807 | 2019-07-19 |
| 1962054528 | Erik I Garcia | Behavior Technician | 4937 Edmonton St, Fontana, CA 92336-0633 | 2019-07-14 |
| Find all providers in FONTANA | ||||
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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.