JAKE H HOUSHMAND
Complete NPI Record 1245883941
Behavior Technician in Yuba City, CA

NPI Status: Active since July 22, 2019

Contact Information

990 KLAMATH LN STE 20
YUBA CITY, CA
ZIP 95993
Phone: (916) 729-3098

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Complete NPI Dataset

This page represents the complete record for NPI 1245883941. 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: 1245883941
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
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).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: JAKE
The first name of the provider, if the provider is an individual.
Provider Middle Name: H
The middle name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 990 KLAMATH LN STE 20
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 Mailing Address City Name: YUBA CITY
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Mailing Address State Name: CA
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: 959938979
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: 9167293098
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: 990 KLAMATH LN STE 20
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 City Name: YUBA CITY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 959938979
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9167293098
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 7/22/2019
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Last Update Date: 7/22/2019
The first name of the authorized official.
Provider Gender Code: M
The middle name of the authorized official.
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: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No