Active NPI
Samantha Klebanow, BCBA
- Behavior Analyst
- Irvine, CA
National Provider Identifier
1134559966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-13-14654
- Practice address
- 16782 Von Karman Ave Ste 11
Irvine, CA 92606 - Phone
- (949) 833-2237
- NPI assigned
- Nov 14, 2013
- Sex
- Female
- 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 | 1-13-14654 | AZ | Primary |
Addresses
Primary practice location
16782 Von Karman Ave Ste 11
Irvine, CA 92606
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (949) 833-2237
Other practice location 1
4530 E Muirwood Dr
Suite 103
Phoenix, AZ 85048-7639
Phone (480) 610-6981 ext. 16
Other practice location 2
4530 E Muirwood Dr
Suite 103
Phoenix, AZ 85048-7639
Phone (480) 610-6981 ext. 16
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1134559966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16782 VON KARMAN AVE STE 11",
"city": "IRVINE",
"state": "CA",
"postal_code": "926062417",
"telephone_number": "949-833-2237",
"fax_number": "480-898-7419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16782 VON KARMAN AVE STE 11",
"city": "IRVINE",
"state": "CA",
"postal_code": "92606",
"telephone_number": "949-833-2237"
}
],
"practiceLocations": [
{
"address_1": "4530 E Muirwood Dr",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850487639",
"country_code": "US",
"telephone_number": "480-610-6981 x16",
"fax_number": "480-898-7419",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4530 E Muirwood Dr",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850487639",
"country_code": "US",
"telephone_number": "480-610-6981 x16",
"fax_number": "480-898-7419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLEBANOW",
"first_name": "SAMANTHA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-14",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "1-13-14654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.