Marine Avagyan, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-71351 Issued in CA

Practice address

150 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7237

Phone

(707) 553-1784

Fax

(510) 373-1738

NPI assigned

Feb 22, 2018

Last updated

Mar 8, 2024By the provider in NPPES

Sex

Female

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

State licenses

Practice roles

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

• Advance Education, Inc.

  dba Capitol Autism Services

  • Behavior Analyst
  • Sacramento, CA
  • NPI 1578856977
  NPD (past)
• Unityaba Inc.

  • Community/Behavioral Health Agency
  • Sacramento, CA
  • NPI 1144076852
  NPD (past)

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1245731462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917237",
            "telephone_number": "707-553-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917237",
            "telephone_number": "707-553-1784",
            "fax_number": "510-373-1738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2751 Wilmington Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958201048",
            "country_code": "US",
            "telephone_number": "916-923-1789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Royal Oaks Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958154235",
            "country_code": "US",
            "telephone_number": "916-923-1789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8950 Cal Center Dr Ste 137",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958263236",
            "country_code": "US",
            "telephone_number": "916-923-1789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVAGYAN",
        "first_name": "MARINE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "16-15400",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-24-71351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arielle M Atkinson
• William G Auer, OTRL
• Marian August, DO
• Matthew Friend Ausfahl
• Sherman Auyeung, DPT
• Amanda Lyn Avelino
• Menlo Jayson Avestro II
• Steffany Avila
• Yeraldine Avila
• Hisham Awadalla, PHARMD

• Behavior Analyst in Vallejo, CA
• Providers in Vallejo, 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 8, 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.