Individual provider Active NPI

Babak Zolfaghari-Azar, MS, QMHP

  • Behavior Analyst
  • Salem, OR
National Provider Identifier
1013321348
Registry record updated Jun 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2905 River Rd S
Salem, OR 97302-9754
Phone
(503) 602-0545
Fax
(503) 391-6337
NPI assigned
Jun 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

2905 River Rd S
Salem, OR 97302-9754

Mailing address

2905 River Rd S
Salem, OR 97302-9754
Phone (503) 602-0545

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
Credentials
Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402704000000",
    "number": "1013321348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 RIVER RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-602-0545",
            "fax_number": "503-391-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 RIVER RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029754",
            "telephone_number": "503-602-0545",
            "fax_number": "503-391-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLFAGHARI-AZAR",
        "first_name": "BABAK",
        "credential": "MS, QMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-14",
        "last_updated": "2014-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.