Justin Purdom
Individual provider Active NPI Behavior Analyst · El Dorado Hills, CA
NPI 1245923671 · NPPES record last updated May 31, 2023
Key facts
- NPI
- 1245923671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 4980 Hillsdale Cir Ste Abc
El Dorado Hills, CA 95762-5726 - Phone
- (916) 693-6469
- NPI assigned
- May 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | Yes |
Addresses
Primary practice location
4980 Hillsdale Cir Ste Abc
El Dorado Hills, CA 95762-5726
Mailing address
4980 Hillsdale Cir Ste Abc
El Dorado Hills, CA 95762-5726
Phone (916) 693-6469
Other providers in El Dorado Hills, CA
- Caliya Pride Thomas
- Prime Wellness LLC
- Private Healthcare Facilities
- Rika Prodhan-Ashraf
- Proplay Pediatric Physical Therapy, Inc.
- Ian Purnell
- Jamesha Quindt
- Isabella Quintero
- Qura Healthcare Inc
- Qura Hospice Inc
All providers in El Dorado Hills, CA · Behavior Analyst in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.