NPIMap

Organization Active NPI

Autism and Developmental Intervention Services, Inc.

  • Behavior Analyst
  • Murrieta, CA
National Provider Identifier
1144776287
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
AUTISM AND DEVELOPMENTAL INTERVENTION SERVICES, INC.
Practice address
23811 Washington Ave C110-296
Murrieta, CA 92562-2267
Phone
(714) 472-3660
Fax
(951) 304-0390
NPI assigned
Aug 29, 2016
Last updated
Aug 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Authorized official

Name
Ms. Brandi Tavis, M.ED., B.C.B.A.
Title
Vice-President/Cfo
Phone
(714) 472-3660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

23811 Washington Ave C110-296
Murrieta, CA 92562-2267

Mailing address

23811 Washington Ave C110-296
Murrieta, CA 92562-2267
Phone (714) 472-3660

National Provider Directory

National Provider Directory

Locations

23811 Washington Ave
#C110296
Murrieta, CA 92562
Phone (951) 290-1175

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535500800000",
    "number": "1144776287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23811 WASHINGTON AVE C110-296",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622267",
            "telephone_number": "714-472-3660",
            "fax_number": "951-304-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23811 WASHINGTON AVE C110-296",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622267",
            "telephone_number": "714-472-3660",
            "fax_number": "951-304-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM AND DEVELOPMENTAL INTERVENTION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2018-08-29",
        "status": "A",
        "authorized_official_last_name": "TAVIS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "VICE-PRESIDENT/CFO",
        "authorized_official_telephone_number": "714-472-3660",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., B.C.B.A."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.