Individual provider Active NPI

Emma Nicole Gardner

  • Behavior Analyst
  • Ridgecrest, CA
National Provider Identifier
1124689427
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-35849 Issued in CA
Practice address
517 Randall St
Ridgecrest, CA 93555-3305
Phone
(818) 445-7856
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 1-19-35849 CA Primary

Addresses

Primary practice location

517 Randall St
Ridgecrest, CA 93555-3305

Mailing address

517 Randall St
Ridgecrest, CA 93555-3305
Phone (818) 445-7856

Other practice location 1

16946 Sherman Way
Van Nuys, CA 91406-3613
Phone (818) 401-0661

Other practice location 2

525 W Ward Ave Apt B
Ridgecrest, CA 93555-3040
Phone (818) 445-7856

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Unique Behavioral Services Behavior Analyst CurrentSince May 1, 2022 Accepting new patients
Comprehensive Unique Behavioral Services, LLC CurrentSince Aug 17, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1124689427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 RANDALL ST",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553305",
            "telephone_number": "818-445-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 RANDALL ST",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553305",
            "telephone_number": "818-445-7856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16946 Sherman Way",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914063613",
            "country_code": "US",
            "telephone_number": "818-401-0661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 W Ward Ave Apt B",
            "address_purpose": "LOCATION",
            "city": "Ridgecrest",
            "state": "CA",
            "postal_code": "935553040",
            "country_code": "US",
            "telephone_number": "818-445-7856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "EMMA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-35849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.