Active NPI
Aleasha Nicol Clark
- Behavior Technician
- Portland, OR
National Provider Identifier
1023588233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 205 SE Spokane St Ste 329
Portland, OR 97202-6495 - Phone
- (818) 241-6780
- NPI assigned
- Nov 30, 2018
- Sex
- Female
- Sole proprietor
- No
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 | X085290006 | MO | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
205 SE Spokane St Ste 329
Portland, OR 97202-6495
Mailing address
1055 E Colorado Blvd Ste 560
Pasadena, CA 91106-2380
Phone (818) 241-6780
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 |
|---|---|---|---|
| X085290006 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1023588233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 E COLORADO BLVD STE 560",
"city": "PASADENA",
"state": "CA",
"postal_code": "911062380",
"telephone_number": "818-241-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 SE SPOKANE ST STE 329",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972026495",
"telephone_number": "818-241-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ALEASHA",
"middle_name": "NICOL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-30",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "X085290006",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.