Individual provider Active NPI

Jon Bamba, BCBA, LBA

  • Behavior Analyst
  • Upper Marlboro, MD
National Provider Identifier
1154837144
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA2225 Issued in MD
Practice address
4741 Colonel Ashton PL
Upper Marlboro, MD 20772-2881
Phone
(808) 300-9059
NPI assigned
Dec 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 LBA2225 MD Primary

Addresses

Primary practice location

4741 Colonel Ashton PL
Upper Marlboro, MD 20772-2881

Mailing address

1314 S. Grand Blvd Ste 2 PMB 238
Spokane, WA 99202
Phone (808) 300-9059

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
BA-725HIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Kupukupu Consulting Hawaii, LLC Behavior Analyst CurrentSince Oct 15, 2023 Accepting new patients
L.E.a.P.S and Beyond, Inc Past Accepting new patients

Locations

65-1692 Kohala Mountain Rd
Kamuela, HI 96743
Phone (808) 300-9059

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": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1154837144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 S. GRAND BLVD STE 2 PMB 238",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99202",
            "telephone_number": "808-300-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 COLONEL ASHTON PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722881",
            "telephone_number": "808-300-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBA",
        "first_name": "JON",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-28",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA2225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.