Individual provider Active NPI

Deborah Van Tuyl, BCBA

  • Behavior Analyst
  • Concord, CA
National Provider Identifier
1134569171
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11312944 Issued in CA
Practice address
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Phone
(510) 832-4383
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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 11312944 CA Primary

Addresses

Primary practice location

1200 Concord Ave Ste 100
Concord, CA 94520-4969

Mailing address

577 S 6TH St
San Jose, CA 95112-5659
Phone (408) 591-6348

Other practice location 1

577 S 6th St
San Jose, CA 95112-5659
Phone (408) 591-6348

Other identifiers 1

IdentifierTypeStateIssuer
11312944OtherCABOARD CERTIFIED BEHAVIOR ANALYST

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

State licenses

LicenseStateTypeSpecialty
11312944CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stones Center for Autistic Spectrum Disorders, Inc. Behavior Analyst Past Accepting new patients
Red House Behavior Resources, Inc. Behavior Analyst Past 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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1134569171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 S 6TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125659",
            "telephone_number": "408-591-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CONCORD AVE STE 100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204969",
            "telephone_number": "510-832-4383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "577 S 6th St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951125659",
            "country_code": "US",
            "telephone_number": "408-591-6348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN TUYL",
        "first_name": "DEBORAH",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11312944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFIED BEHAVIOR ANALYST",
            "identifier": "11312944",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

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

Verify at the official NPI Registry.