Individual provider Active NPI

Patricia Pebbles Gminder, BCBA

  • Behavior Analyst
  • Sun City, CA
National Provider Identifier
1164804241
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11518513 Issued in CA
Practice address
27070 Sun City Blvd
Sun City, CA 92586-2509
Phone
(951) 448-7035
NPI assigned
Jun 24, 2015
Last updated
Jun 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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 11518513 CA Primary

Addresses

Primary practice location

27070 Sun City Blvd
Sun City, CA 92586-2509

Mailing address

27070 Sun City Blvd
Sun City, CA 92586-2509
Phone (951) 448-7035

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
11518513CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Guiding Behavior Outcomes LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1164804241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27070 SUN CITY BLVD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862509",
            "telephone_number": "951-448-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27070 SUN CITY BLVD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862509",
            "telephone_number": "951-448-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GMINDER",
        "first_name": "PATRICIA",
        "middle_name": "PEBBLES",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11518513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.