Active NPI
Joan Shin
- Behavior Analyst
- San Diego, CA
National Provider Identifier
1013332097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11314180
- Practice address
- 3954 Murphy Canyon Rd
San Diego, CA 92123-4418 - Phone
- (858) 225-9020
- NPI assigned
- Feb 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11314180 | CA | Primary |
| School Psychologist | 103TS0200X | 101091874 | CA |
Addresses
Primary practice location
3954 Murphy Canyon Rd
San Diego, CA 92123-4418
Mailing address
11168 Raju St
San Diego, CA 92129-1218
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 |
|---|---|---|---|
| 11314180 | CA | MD | Behavioral Analyst |
| 101091874 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393459200000",
"number": "1013332097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11168 RAJU ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921291218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3954 MURPHY CANYON RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234418",
"telephone_number": "858-225-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "JOAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-27",
"last_updated": "2014-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "11314180",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "101091874",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.