Active NPI
Channara Tep
- Behavior Analyst
- Pasadena, CA
National Provider Identifier
1003262155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- F5763065
- Practice address
- 625 S Fair Oaks Ave
Suite 200
Pasadena, CA 91105-2613 - Phone
- (323) 341-5580
- NPI assigned
- May 9, 2016
- Sex
- Male
- 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 | F5763065 | CA | Primary |
Addresses
Primary practice location
625 S Fair Oaks Ave
Suite 200
Pasadena, CA 91105-2613
Mailing address
625 S Fair Oaks Ave
Suite 200
Pasadena, CA 91105-2613
Phone (323) 341-5580
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F5763065 | CA | MD | Behavioral Analyst |
Interoperability endpoints
- https://api.platform.athenahealth.com/20931/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462752000000",
"number": "1003262155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 S FAIR OAKS AVE",
"address_2": "SUITE 200",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052613",
"telephone_number": "323-341-5580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 S FAIR OAKS AVE",
"address_2": "SUITE 200",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052613",
"telephone_number": "323-341-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEP",
"first_name": "CHANNARA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-09",
"last_updated": "2016-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "F5763065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.