Open Spectrum Behavior Therapy

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-11-9431

Legal business name

OPEN SPECTRUM BEHAVIOR THERAPY

Practice address

2625 Alcatraz Ave Ste 609
Berkeley, CA 94705

Phone

(650) 208-8320

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Benjamin Tucker, M.S., LPCC, BCBA

Title

Owner

Phone

(650) 208-8320

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1265945844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 ALCATRAZ AVE STE 609",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 ALCATRAZ AVE STE 609",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94705",
            "telephone_number": "650-208-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN SPECTRUM BEHAVIOR THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-208-8320",
        "authorized_official_credential": "M.S., LPCC, BCBA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "PCC5297",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-11-9431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Berkeley, CA
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• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.