Active NPI
William Henry Brandom, PH.D, BCBA-D
- Behavior Analyst
- Citrus Heights, CA
National Provider Identifier
1114246352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-04-1787
- Practice address
- 6400 Tupelo Dr
Citrus Heights, CA 95621-1741 - Phone
- (916) 729-3098
- Fax
- (916) 729-3006
- NPI assigned
- May 27, 2010
- Sex
- Male
- 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 | 1-04-1787 | CA | Primary |
Addresses
Primary practice location
6400 Tupelo Dr
Citrus Heights, CA 95621-1741
Mailing address
6400 Tupelo Dr
Citrus Heights, CA 95621-1741
Phone (916) 729-3098
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
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274918400000",
"number": "1114246352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 TUPELO DR",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956211741",
"telephone_number": "916-729-3098",
"fax_number": "916-729-3006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 TUPELO DR",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956211741",
"telephone_number": "916-729-3098",
"fax_number": "916-729-3006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDOM",
"first_name": "WILLIAM",
"middle_name": "HENRY",
"credential": "PH.D, BCBA-D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-27",
"last_updated": "2010-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-04-1787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.