Bobby Canas

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-78191 Issued in CA

Practice address

12395 Lewis St Ste 102
Garden Grove, CA 92840-4698

Phone

(760) 634-1125

NPI assigned

Feb 5, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1215569629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 LEWIS ST STE 102",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404698",
            "telephone_number": "760-634-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 LEWIS ST STE 102",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404698",
            "telephone_number": "760-634-1125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 E Colorado Blvd Ste 560",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911062380",
            "country_code": "US",
            "telephone_number": "818-241-6780",
            "fax_number": "818-241-6853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANAS",
        "first_name": "BOBBY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-05",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-24-78191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.