Shannon Nicole Stanford, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-34024 Issued in CA

Practice address

5435 Balboa Blvd Ste 202
Encino, CA 91316-1570

Phone

(818) 987-8104

Fax

(310) 933-4134

NPI assigned

Feb 5, 2019

Last updated

Feb 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Alive Education Management and Services

  • Community/Behavioral Health Agency
  • Beverly Hills, CA
  • NPI 1427608967
  Authorized official Same address or phone

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1023573938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 LOUISE AVE",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914065435",
            "telephone_number": "818-795-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 BALBOA BLVD STE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161570",
            "telephone_number": "818-987-8104",
            "fax_number": "310-933-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-18-34024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA",
            "identifier": "1-18-34024",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin Stachowski
• Judith Frankel Stahl, L.M.F.T.
• Janice Stallings
• Daniel Stanescu, PTA
• Erin Marisa Stanford, MA, OTR/L
• Edward Donald Stanislawski, D.C., C.S.C.S.
• Stanley J. Leiken, MD Inc.
• Stanley M Kopelow M D Inc
• Starbright Medical Clinic Inc
• Ariella Stark

• Behavior Analyst in Encino, CA
• Providers in Encino, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.