Individual provider Active NPI

Amy J Machado, M.A., BCBA

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1205192093
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-12-10466 Issued in CA
Practice address
625 Pennsylvania Ave
San Diego, CA 92103-4321
Phone
(858) 603-6628
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2016

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 1-12-10466 CA Primary

Addresses

Primary practice location

625 Pennsylvania Ave
San Diego, CA 92103-4321

Mailing address

3136 Vancouver Ave
San Diego, CA 92104-4835
Phone (615) 330-6415

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1205192093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 VANCOUVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044835",
            "telephone_number": "615-330-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PENNSYLVANIA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034321",
            "telephone_number": "858-603-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHADO",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "M.A., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-12-10466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.