Sivan So, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA61054733 Issued in WA

Practice address

22845 SE 1St PL Apt 215
Sammamish, WA 98074-5038

Phone

(805) 668-8961

Fax

(208) 416-6922

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1205463577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22845 SE 1ST PL APT 215",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980745038",
            "telephone_number": "805-668-8961",
            "fax_number": "208-416-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22845 SE 1ST PL APT 215",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980745038",
            "telephone_number": "805-668-8961",
            "fax_number": "208-416-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "SIVAN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "BA61054733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DEPARTMENT OF HEALTH",
            "identifier": "BA61054733",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B.A.C.B.",
            "identifier": "1-20-41787",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meenakshi Singh
• Cale Smart
• Liudmila Smelovskaia
• Brandon E Smith, MSN, FNP-C
• Robert B Smith Jr., PSYD
• Emily Alene Solie, PT
• Sometimes Quiet Desperation
• Christopher S Son
• Wenjia Song, ARNP
• Speech Therapy by Elisabeth, LLC

• Behavior Analyst in Sammamish, WA
• Providers in Sammamish, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.