Individual provider Active NPI

Stephanie Anyakwo, M.A., BCBA

  • Behavior Analyst
  • Hermosa Beach, CA
National Provider Identifier
1124406459
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
201337841 Issued in CA
Practice address
2447 Pacific Coast Hwy
Hermosa Beach, CA 90254-2714
Phone
(310) 374-3300
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 201337841 CA Primary

Addresses

Primary practice location

2447 Pacific Coast Hwy
Hermosa Beach, CA 90254-2714

Mailing address

1738 E Califon St
Carson, CA 90745-1826

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
201337841CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1124406459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 E CALIFON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907451826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 PACIFIC COAST HWY",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542714",
            "telephone_number": "310-374-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYAKWO",
        "first_name": "STEPHANIE",
        "credential": "M.A., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "201337841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermosa Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.

Verify at the official NPI Registry.