Active NPI
Bryanna Nicole Pongraphan, BCABA
- Behavior Analyst
- Garden Grove, CA
National Provider Identifier
1083955835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0-13-5266
- Practice address
- 12443 Lewis St
Garden Grove, CA 92840-4650 - Phone
- (714) 748-4440
- NPI assigned
- Mar 4, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0-13-5266 | CA | Primary |
Addresses
Primary practice location
12443 Lewis St
Garden Grove, CA 92840-4650
Mailing address
28 Meridian Dr
Aliso Viejo, CA 92656-2696
Phone (949) 350-3811
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422316800000",
"number": "1083955835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 MERIDIAN DR",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "926562696",
"telephone_number": "949-350-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12443 LEWIS ST",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928404650",
"telephone_number": "714-748-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONGRAPHAN",
"first_name": "BRYANNA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "BCABA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-04",
"last_updated": "2015-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "0-13-5266",
"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 Jan 27, 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.