Active NPI
Angela Pao-Johnson, BCBA
- Behavior Analyst
- Crandall, TX
National Provider Identifier
1003189242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-09-6526
- Practice address
- 125 Haymeadow Dr
Crandall, TX 75114-5138 - Phone
- (346) 330-0308
- NPI assigned
- Feb 20, 2012
- Last updated
- Oct 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-09-6526 | CA | Primary |
Addresses
Primary practice location
125 Haymeadow Dr
Crandall, TX 75114-5138
Mailing address
306 N Kensington Ave
La Grange, IL 60526-1870
Phone (346) 330-0308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Learning Collaborative LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Albuquerque, NM
- NPI 1578173472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1003189242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 N KENSINGTON AVE",
"city": "LA GRANGE",
"state": "IL",
"postal_code": "605261870",
"telephone_number": "346-330-0308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 HAYMEADOW DR",
"city": "CRANDALL",
"state": "TX",
"postal_code": "751145138",
"telephone_number": "346-330-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAO-JOHNSON",
"first_name": "ANGELA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-20",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-09-6526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crandall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.