Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 106E00000X | Assistant Behavior Analyst | | | | No |
| 2 | 106S00000X | Behavior Technician | | | | No |
| 3 | 174H00000X | Health Educator | | | | No |
| 4 | 251300000X | Local Education Agency (LEA) | | | | No |
| 5 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 6 | 251S00000X | Community/Behavioral Health | | | | No |
| 7 | 252Y00000X | Early Intervention Provider Agency | | | | No |
| 8 | 261QD1600X | Clinic/Center | Developmental Disabilities | | | No |
| 9 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 10 | 261QR1100X | Clinic/Center | Research | | | No |
| 11 | 103K00000X | Behavior Analyst | | 1-14-17867 | CALIFORNIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 1265822480 | OTHER | CALIFORNIA | NPI TYPE 1 |
