NPIMap

Organization Active NPI

ABA Weissenberg Elite Behavioral Services

  • Community/Behavioral Health Agency
  • Newport Beach, CA
National Provider Identifier
1265912919
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1-14-10119 Issued in CA
Legal business name
ABA WEISSENBERG ELITE BEHAVIORAL SERVICES
Practice address
4930 Campus Dr
Newport Beach, CA 92660-2119
Phone
(208) 995-3615
Fax
(833) 275-1309
NPI assigned
Aug 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Laura Dickerson, BCBA
Title
Clinical Director
Phone
(208) 995-3615

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-14-10119 CA
Community/Behavioral Health Agency 251S00000X 1-14-10119 CA Primary

Addresses

Primary practice location

4930 Campus Dr
Newport Beach, CA 92660-2119

Mailing address

PO Box 1519
Meridian, ID 83680-1519
Phone (208) 995-3615

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1265912919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1519",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836801519",
            "telephone_number": "208-995-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 CAMPUS DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602119",
            "telephone_number": "208-995-3615",
            "fax_number": "833-275-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA WEISSENBERG ELITE BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "208-995-3615",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-14-10119",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "1-14-10119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.