Organization Active NPI

Optimum ABA Services

  • Behavior Analyst
  • Modesto, CA
National Provider Identifier
1083300503
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
OPTIMUM ABA SERVICES
Practice address
3430 Tully Rd Ste 20-1082
Modesto, CA 95350-0840
Phone
(209) 232-6786
Fax
(209) 232-6787
NPI assigned
Apr 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Jonathan Bruno, BCBANPI 1265785588
Title
Executive Director
Phone
(209) 232-6786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

3430 Tully Rd Ste 20-1082
Modesto, CA 95350-0840

Mailing address

3430 Tully Rd Ste 20-1082
Modesto, CA 95350-0840
Phone (209) 232-6786

Other names 1

  • Optimum Other name

National Provider Directory

National Provider Directory

Locations

3430 Tully Rd
Ste 201082
Modesto, CA 95350
Phone (209) 232-6786

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1083300503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 TULLY RD STE 20-1082",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500840",
            "telephone_number": "209-232-6786",
            "fax_number": "209-232-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 TULLY RD STE 20-1082",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500840",
            "telephone_number": "209-232-6786",
            "fax_number": "209-232-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM ABA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-232-6786",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.