Active NPI
Jadon Singer Lasley
- Behavior Analyst
- Rohnert Park, CA
National Provider Identifier
1013493808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 00005910
- Practice address
- 2 Padre Pkwy Ste 101
Rohnert Park, CA 94928-2114 - Phone
- (707) 553-1784
- NPI assigned
- Jul 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 00005910 | CA | Primary |
Addresses
Primary practice location
2 Padre Pkwy Ste 101
Rohnert Park, CA 94928-2114
Mailing address
121 Lichtenberg Ave
Sonoma, CA 95476-3622
Phone (707) 934-7095
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 |
|---|---|---|---|
| 00005910 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531526400000",
"number": "1013493808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 LICHTENBERG AVE",
"city": "SONOMA",
"state": "CA",
"postal_code": "954763622",
"telephone_number": "707-934-7095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 PADRE PKWY STE 101",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "949282114",
"telephone_number": "707-553-1784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASLEY",
"first_name": "JADON",
"middle_name": "SINGER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-14",
"last_updated": "2018-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "00005910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rohnert Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.