Active NPI
Devon Schutt
- Behavior Analyst
- Elk Grove, CA
National Provider Identifier
1255809208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-56609
- Practice address
- 9355 E Stockton Blvd Ste 100
Elk Grove, CA 95624-9476 - Phone
- (916) 683-1109
- Fax
- (916) 683-1140
- NPI assigned
- Nov 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-56609 | CA | Primary |
| Behavior Technician | 106S00000X | 17-46970 | CA |
Addresses
Primary practice location
9355 E Stockton Blvd Ste 100
Elk Grove, CA 95624-9476
Mailing address
PO Box 5157
Modesto, CA 95352-5157
Phone (209) 572-2589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-46970 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Pathways, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Modesto, CA
- NPI 1962638486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1255809208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5157",
"city": "MODESTO",
"state": "CA",
"postal_code": "953525157",
"telephone_number": "209-572-2589",
"fax_number": "209-572-1461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9355 E STOCKTON BLVD STE 100",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956249476",
"telephone_number": "916-683-1109",
"fax_number": "916-683-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUTT",
"first_name": "DEVON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-07",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-21-56609",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "17-46970",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.