IndividualActive
Souraxay Chanthavong
NPI 1215606892 · Behavior Technician · Santa Rosa, CA
Souraxay Chanthavong is a Behavior Technician provider in Santa Rosa, CA (NPI 1215606892).
Provider details
- NPI number
- 1215606892
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1335 N Dutton Ave
Santa Rosa, CA 95401-4609
Phone: (855) 223-7123
Street-level locationGet directions
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Registry dates
- Enumerated
- 2021-09-08
- Last updated
- 2021-09-08
- Certified
- 2021-09-08
Frequently asked questions
- What is Souraxay Chanthavong's NPI number?
- Souraxay Chanthavong's National Provider Identifier (NPI) is 1215606892, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Souraxay Chanthavong's specialty?
- Souraxay Chanthavong is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Souraxay Chanthavong located?
- Souraxay Chanthavong's practice location on file with NPPES is 1335 N Dutton Ave, Santa Rosa, CA 95401-4609.
- What is Souraxay Chanthavong's phone number?
- The practice phone number listed in the NPPES registry for Souraxay Chanthavong is (855) 223-7123.
- Is Souraxay Chanthavong's NPI active?
- Yes — Souraxay Chanthavong's NPI (1215606892) is active in the NPPES registry as of the last update on 2021-09-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.