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  7. NPI Record 1184456329

KATHERINE VAN MOURIK
Complete NPI Record 1184456329
Behavior Technician in Rocklin, CA

NPI Status: Active since August 16, 2024

Contact Information

6560 LONETREE BLVD STE 100
ROCKLIN, CA
ZIP 95765
Phone: (866) 523-4268

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Provider Gender Code
  20. Healthcare Provider Taxonomy Code 1
  21. Healthcare Provider Primary Taxonomy Switch 1
  22. Is Sole Proprietor
  23. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1184456329. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1184456329
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Name: KATHERINE
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 850 TOWBIN AVE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: LAKEWOOD
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NJ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 087015928
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 8335992560
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 6560 LONETREE BLVD STE 100
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Practice Location Address City Name: ROCKLIN
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Practice Location Address State Name: CA
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Practice Location Address Postal Code: 957655891
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address Country Code If outside U S : US
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Telephone Number: 8665234268
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Enumeration Date: 8/16/2024
The city name in the location address of the provider being identified.
Last Update Date: 8/16/2024
The State code in the location of the provider being identified.
Provider Gender Code: F
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Healthcare Provider Taxonomy Code 1: 106S00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 8/16/2024