Stephanie Ilagan Waldo, M.S., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-39189

Practice address

6560 Lonetree Blvd Ste 100
Rocklin, CA 95765-5891

Phone

(866) 523-4268

NPI assigned

Apr 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Aquino Ilagan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Arts, Master of Science

Practice roles

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

• A Is for Apple

  • Psychologist
  • San Jose, CA
  • NPI 1578891925

  Behavior Analyst

  NPD (past)
• Kadiant, LLC

  • Behavior Analyst
  • Oakland, CA
  • NPI 1811547052
  NPD (past)

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1215434238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 22763",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911852763",
            "telephone_number": "866-523-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 LONETREE BLVD STE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655891",
            "telephone_number": "866-523-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "STEPHANIE",
        "middle_name": "ILAGAN",
        "name_prefix": "Mrs.",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-39189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ILAGAN",
            "middle_name": "AQUINO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Johanna Tu Tram Vu
• Craig S Wada, D.D.S.
• Dawn Wade, MA, LMFT, ATR, CHT
• Elijah Wade
• Eric Donald Wagnon, D.C.
• Krista Kelly Waldschmidt
• Walgreen Co (Walgreens #06915)
• Steven Wall
• Madison Taylor Wallace
• Arionna Unique Honistee Waller

• Behavior Analyst in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.