Active NPI
Samah Sabry Youssef Awadalla
- Behavior Analyst
- San Ramon, CA
National Provider Identifier
1174169023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 872 Spring Brook Dr
San Ramon, CA 94582-5632 - Phone
- (407) 760-5574
- NPI assigned
- Nov 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Y2775723 | CA | |
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
872 Spring Brook Dr
San Ramon, CA 94582-5632
Mailing address
872 Spring Brook Dr
San Ramon, CA 94582-5632
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 |
|---|---|---|---|
| Y2775723 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1174169023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "872 SPRING BROOK DR",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945825632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 SPRING BROOK DR",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945825632",
"telephone_number": "407-760-5574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUSSEF AWADALLA",
"first_name": "SAMAH",
"middle_name": "SABRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-25",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "Y2775723",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.