Active NPI
John Will Hubbard IV
- Behavior Analyst
- Fairfield, CA
National Provider Identifier
1205312436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3426 Glen Ellen Dr
Fairfield, CA 94534 - Phone
- (916) 271-3419
- NPI assigned
- Jul 11, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
3426 Glen Ellen Dr
Fairfield, CA 94534
Mailing address
3426 Glen Ellen Dr
Fairfield, CA 94534-7957
Phone (916) 271-3419
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532476800000",
"number": "1205312436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3426 GLEN ELLEN DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945347957",
"telephone_number": "916-271-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3426 GLEN ELLEN DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94534",
"telephone_number": "916-271-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "JOHN",
"middle_name": "WILL",
"name_suffix": "IV",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-11",
"last_updated": "2018-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.