NPIMap

Organization Active NPI

Behavioral Support Partnership

  • Behavior Analyst
  • Garden Grove, CA
National Provider Identifier
1033593397
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-18868 Issued in CA
Legal business name
BEHAVIORAL SUPPORT PARTNERSHIP
Practice address
12443 Lewis St
Suite 201
Garden Grove, CA 92840-4650
Phone
(714) 748-4440
NPI assigned
Jul 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Authorized official

Name
Miss Crystal Michelle Gutierrez, M.A., BCBA
Title
Case Supervisor
Phone
(818) 304-1313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-15-18868 CA Primary

Addresses

Primary practice location

12443 Lewis St
Suite 201
Garden Grove, CA 92840-4650

Mailing address

522 Wycliffe
Irvine, CA 92602-1213
Phone (818) 304-1313

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Support Partnership2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1033593397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 WYCLIFFE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021213",
            "telephone_number": "818-304-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12443 LEWIS ST",
            "address_2": "SUITE 201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404650",
            "telephone_number": "714-748-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL SUPPORT PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CASE SUPERVISOR",
        "authorized_official_telephone_number": "818-304-1313",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "M.A., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-15-18868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.