Active NPI
Sergey Sukhanov
- Behavior Analyst
- Los Gatos, CA
National Provider Identifier
1093689317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-25-82798
- Practice address
- 508 Nino Ave
Los Gatos, CA 95032-5518 - Phone
- (408) 636-3879
- NPI assigned
- Sep 30, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | 1-25-82798 | CA | Primary |
Addresses
Primary practice location
508 Nino Ave
Los Gatos, CA 95032-5518
Mailing address
5504 Don Rodolfo CT
San Jose, CA 95123-3137
Phone (408) 636-3879
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": "1759190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759190400000",
"number": "1093689317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5504 DON RODOLFO CT",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233137",
"telephone_number": "408-636-3879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 NINO AVE",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950325518",
"telephone_number": "408-636-3879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUKHANOV",
"first_name": "SERGEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-30",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-25-82798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.