Active NPI
Colleen Ann McCormick
- Behavior Analyst
- Sacramento, CA
National Provider Identifier
1154807139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 00004855
- Practice address
- 8801 Folsom Blvd
Sacramento, CA 95826-3257 - Phone
- (916) 382-4447
- NPI assigned
- Jul 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 00004855 | CA | Primary |
Addresses
Primary practice location
8801 Folsom Blvd
Sacramento, CA 95826-3257
Mailing address
1315 Rolling Hills Dr
Roseville, CA 95661-5449
Phone (916) 677-6840
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00004855 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531440000000",
"number": "1154807139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 ROLLING HILLS DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956615449",
"telephone_number": "916-677-6840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 FOLSOM BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958263257",
"telephone_number": "916-382-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "COLLEEN",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-13",
"last_updated": "2018-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "00004855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.