Xtraordinary Spot

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

XTRAORDINARY SPOT

Practice address

4372 Almaterra Dr
Perris, CA 92571-5112

Phone

(562) 235-7456

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Sarde Stewart, MS BCBANPI 1063024206

Title

Clinical Director

Phone

(909) 997-8496

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarde Stewart, M.S

  • Behavior Analyst
  • Victorville, CA
  • NPI 1063024206
  NPD Authorized official
• Lorie Moore, B.A.

  • Behavior Technician
  • Perris, CA
  • NPI 1316817653
  NPD

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1215645833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 PINE CT",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712673",
            "telephone_number": "909-997-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4372 ALMATERRA DR",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925715112",
            "telephone_number": "562-235-7456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Pine Ct",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925712673",
            "country_code": "US",
            "telephone_number": "909-997-8496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "XTRAORDINARY SPOT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "SARDE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "909-997-8496",
        "authorized_official_credential": "MS BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Monique L. Young
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• Behavior Analyst in Perris, CA
• Providers in Perris, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.