Earllise U Bogan

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

23842 Hawthorne Blvd Ste 100-101
Torrance, CA 90505-5929

Phone

(424) 999-2990

NPI assigned

Apr 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Center for Autism & Related Disorders, LLC

  • Behavior Analyst
  • Peachtree City, GA
  • NPI 1689320814
  NPD

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1154065449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 GRANITE PKWY STE 600",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246753",
            "telephone_number": "469-694-1754",
            "fax_number": "818-448-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23842 HAWTHORNE BLVD STE 100-101",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055929",
            "telephone_number": "424-999-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "EARLLISE",
        "middle_name": "U",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-23",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sara Bocanegra, MA
• Francisco J Bodan, LCSW
• Hannah Elizabeth Bodenhamer, MS, RD
• Paul Bodin
• Megan Michelle Boehmer, ACSW
• Hassan Bogsara, DDS
• Evan Robert Bohnenblust, MD
• Mary Bohorquez
• Shilpa Atish Bokil
• Franklin Bolanos

• Behavior Analyst in Torrance, CA
• Providers in Torrance, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; 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.