Pediatric Neurology Therapeutics

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11624696 Issued in CA

Legal business name

PEDIATRIC NEUROLOGY THERAPEUTICS

Practice address

7090 Miratech Dr
San Diego, CA 92121-3109

Phone

(858) 304-6440

NPI assigned

Mar 23, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Melissa Danielle Knopp, M.S., BCBA

Title

Director

Phone

(201) 819-1499

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1124559950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7090 MIRATECH DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213109",
            "telephone_number": "858-304-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7090 MIRATECH DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213109",
            "telephone_number": "858-304-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROLOGY THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "KNOPP",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-819-1499",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11624696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Elizabeth Pederson, LMFT
• Julia Pederson, DNP
• Thomas Gregg Pederson, MD
• Kathryn Marie Pedgrift, PSY.D.
• Pediatric Cardiology of San Diego
• Pediatric Office Anesthesia Specialists
• Pediatric Orthopedic and Scoliosis Center of San Diego, Inc.
• Pediatric Primary Care Associated Medical Group
• Pediatric Specialty Partners Inc.
• Celeste Pedraza

• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.