JERRY WOODLE (NPI# 1962018697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962018697 |
| Entity Type | Individual |
| Full Name | JERRY WOODLE |
| Practice Address |
12941 Marva Pl Se Albuquerque NM 87123-3811 |
| Practice Telephone | 5053187221 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-10-01 |
| 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 |
| Street Address |
12941 MARVA PL SE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87123-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360291 | Frances J. Dewent | Technician | 504 Aragon St Se, Albuquerque, NM 87123 | 2020-09-09 |
| 1275042293 | Amanda Valdez-androlewicz | Nurse Practitioner | 1117 Monte Largo Dr Ne, Albuquerque, NM 87123 | 2017-09-21 |
| 1740708809 | 11.11, LLC | Case Manager/Care Coordinator | 11724 Copper Pl Ne, Albuquerque, NM 87123 | 2017-09-08 |
| 1710375365 | Diane Crouse | Occupational Therapist | 820 Monte Alto Dr Ne, Albuquerque, NM 87123 | 2015-01-06 |
| 1346640760 | Christopher Trout | Physical Therapist | 11419 Deer Lodge Rd Se, Albuquerque, NM 87123 | 2014-09-04 |
| 1255682944 | Armstrong Medical LLC | Physician Assistant | 13170 Central Ave Se, Suite B 345, Albuquerque, NM 87123 | 2012-09-21 |
| 1467709006 | Tomas Maestas | Emergency Medical Technician, Paramedic | 1515 Eubank Blvd Se Bldg. 831/832, Albuquerque, NM 87123 | 2012-08-14 |
| 1831476951 | Shellie Nicole Field | Pharmacist | 1515 Eubank Se, Bldg 831 Rm 143, Albuquerque, NM 87123 | 2011-11-03 |
| 1023325768 | Moss Trompeter | Pharmacist | 1931 Cam Fella St Se, Albuquerque, NM 87123 | 2010-09-01 |
| 1114239522 | Miguel A. Perez Abreu | Preventive Medicine | 600 Wyoming Blvd Ne, Albuquerque, NM 87123 | 2010-07-14 |
| Find all providers in zip 87123 | ||||
| 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 |
|---|---|---|---|---|
| 1215538343 | Victoria Lopez | Behavior Technician | 1015 Pinatubo Pl Nw, Albuquerque, NM 87120-2974 | 2020-11-04 |
| 1598366080 | Maya Mascarenas | Behavior Technician | 516 Madeira Dr Se Apt 3, Albuquerque, NM 87108-2971 | 2020-11-03 |
| 1831790419 | Alisa Maria Salazar | Behavior Technician | 9610 Arvada Ave Ne, Albuquerque, NM 87112-2912 | 2020-11-02 |
| 1548861065 | Darren Anzures | Behavior Technician | 10004 Benavides Rd Sw, Albuquerque, NM 87121-8126 | 2020-11-02 |
| 1316546286 | Julia Oliver | Behavior Technician | 7717 William Moyers Ave Ne, Albuquerque, NM 87122-2782 | 2020-10-22 |
| 1932708898 | Ann Marie Jean Doolittle Straight | Behavior Technician | 5013 Edwards Dr Ne, Albuquerque, NM 87111-6908 | 2020-10-21 |
| 1114526175 | Alicia Pearl Armijo I | Behavior Technician | 1509 Tierra Verde Pl Sw, Albuquerque, NM 87105-1510 | 2020-10-21 |
| 1285233684 | Michaela Sedillo | Behavior Technician | 1908 Utah St Ne, Albuquerque, NM 87110-4844 | 2020-10-19 |
| 1912506130 | Selena Luisa Wolfel | Behavior Technician | 231 Smith Ave Se, Albuquerque, NM 87102-4754 | 2020-10-19 |
| 1609474105 | Barbara D Mares | Behavior Technician | 5615 Bohemia Ct Sw, Albuquerque, NM 87105-3307 | 2020-10-15 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87123 |
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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.