Mixed Behavior Foundation

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

MIXED BEHAVIOR FOUNDATION

Doing business as

MIXED BEHAVIOR FOUNDATION

Practice address

6955 Foothill Blvd # 275
Oakland, CA 94605-2455

Phone

(925) 430-8295

NPI assigned

Oct 28, 2024

Organization subpart

No

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

Authorized official

Name

Sasha Jackson

Title

Executive Director/Cfo

Phone

(925) 430-8295

Specialties & licenses 1

Addresses

Other names 1

• MIXED BEHAVIOR FOUNDATION Doing business as

Locations

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1245052760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2872 YGNACIO VALLEY RD # 439",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983534",
            "telephone_number": "925-430-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6955 FOOTHILL BLVD # 275",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052455",
            "telephone_number": "925-430-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIXED BEHAVIOR FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SASHA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CFO",
        "authorized_official_telephone_number": "925-430-8295"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIXED BEHAVIOR FOUNDATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Cynthia Mitschang
• Ray Neil Mitsuno, CRNA
• Yumi Mitsuya, M.D.
• James Mittelberger, M.D.
• Tomoko Miwa
• Lekisha Mixon, PSYD
• Annika Mariko Miyamoto, PSYD
• Satoko Miyamoto, D.O.
• Allison Nicole Miyashiro
• Julie Mizera

• Case Management Agency in Oakland, CA
• Providers in Oakland, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.