Individual provider Active NPI

Afshaan Fatema, BCBA

  • Behavior Analyst
  • Garden Grove, CA
National Provider Identifier
1073177697
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
12437 Lewis St Ste 100
Garden Grove, CA 92840-4651
Phone
(940) 536-4763
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

12437 Lewis St Ste 100
Garden Grove, CA 92840-4651

Mailing address

2809 Joshua St
Denton, TX 76209-4875
Phone (940) 536-4763

Other practice location 1

12437 Lewis St Ste 100
Garden Grove, CA 92840-4651
Phone (940) 536-4763

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reach Inc Behavior Analyst Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1073177697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 JOSHUA ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094875",
            "telephone_number": "940-536-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12437 LEWIS ST STE 100",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404651",
            "telephone_number": "940-536-4763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12437 Lewis St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928404651",
            "country_code": "US",
            "telephone_number": "940-536-4763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATEMA",
        "first_name": "AFSHAAN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "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 Mar 27, 2023; 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.