NPIMap

Organization Active NPI

Legacy Behavioral Collective, Inc.

  • Behavior Analyst
  • La Honda, CA
National Provider Identifier
1083542740
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
LEGACY BEHAVIORAL COLLECTIVE, INC.
Practice address
100 Redwood Drive
La Honda, CA 94020-0332
Phone
(650) 799-4776
NPI assigned
May 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Juanita Renee Traver Stine, BCBANPI 1417353954
Title
Owner
Phone
(650) 799-4776

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

100 Redwood Drive
La Honda, CA 94020-0332

Mailing address

PO Box 332
La Honda, CA 94020-0332
Phone (650) 799-4776

National Provider Directory

National Provider Directory

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": "1778544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1083542740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 332",
            "city": "LA HONDA",
            "state": "CA",
            "postal_code": "940200332",
            "telephone_number": "650-799-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 REDWOOD DRIVE",
            "city": "LA HONDA",
            "state": "CA",
            "postal_code": "940200332",
            "telephone_number": "650-799-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY BEHAVIORAL COLLECTIVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-12",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "TRAVER STINE",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-799-4776",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Honda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.