Individual provider Active NPI

Sophie Diane, Nicole Sands, MS

  • Behavior Analyst
  • San Jose, CA
National Provider Identifier
1083214647
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12365081 Issued in CA
Practice address
1922 The Alameda Ste 425
San Jose, CA 95126-1453
Phone
(866) 523-4268
NPI assigned
Oct 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 12365081 CA Primary

Addresses

Primary practice location

1922 The Alameda Ste 425
San Jose, CA 95126-1453

Mailing address

PO Box 399318
San Francisco, CA 94139-9318

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12365081CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Kadiant, LLC 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": "1604102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1083214647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399318",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941399318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 THE ALAMEDA STE 425",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261453",
            "telephone_number": "866-523-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDS",
        "first_name": "SOPHIE",
        "middle_name": "DIANE, NICOLE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-31",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "12365081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.