NPIMap

Organization Active NPI

Olive Branch Autism Services

  • Behavior Analyst
  • Citrus Heights, CA
National Provider Identifier
1124596390
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
OLIVE BRANCH AUTISM SERVICES
Practice address
5750 Sunrise Blvd Ste 210B
Citrus Heights, CA 95610-7639
Phone
(916) 794-2326
Fax
(916) 626-4682
NPI assigned
Nov 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Authorized official

Name
Adam Olives, BCBANPI 1235486168
Title
Bcba Owner
Phone
(916) 794-2326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

5750 Sunrise Blvd Ste 210B
Citrus Heights, CA 95610-7639

Mailing address

5750 Sunrise Blvd Ste 210B
Citrus Heights, CA 95610-7639
Phone (916) 794-2326

Other practice location 1

4832 Arbardee Dr
Fair Oaks, CA 95628-5404
Phone (916) 794-2326

National Provider Directory

National Provider Directory

Locations

5750 Sunrise Blvd
Ste 210B
Citrus Heights, CA 95610
Phone (916) 794-2326

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1124596390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 SUNRISE BLVD STE 210B",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107639",
            "telephone_number": "916-794-2326",
            "fax_number": "916-626-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 SUNRISE BLVD STE 210B",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107639",
            "telephone_number": "916-794-2326",
            "fax_number": "916-626-4682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4832 Arbardee Dr",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956285404",
            "country_code": "US",
            "telephone_number": "916-794-2326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OLIVE BRANCH AUTISM SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "OLIVES",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "BCBA OWNER",
        "authorized_official_telephone_number": "916-794-2326",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 17, 2019; 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.