Individual provider Active NPI

Shauna L. Robertson, BCBA

  • Behavior Analyst
  • Gilbert, AZ
National Provider Identifier
1265980536
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-22904 Issued in AZ
Practice address
82 W Ray Rd
# 104
Gilbert, AZ 85233-8537
Phone
(602) 758-2155
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-16-22904 AZ Primary

Addresses

Primary practice location

82 W Ray Rd
# 104
Gilbert, AZ 85233-8537

Mailing address

1886 E Don Carlos Ave Unit 127
Tempe, AZ 85281-5076
Phone (602) 758-2155

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

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1265980536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1886 E DON CARLOS AVE UNIT 127",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852815076",
            "telephone_number": "602-758-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 W RAY RD",
            "address_2": "# 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852338537",
            "telephone_number": "602-758-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SHAUNA",
        "middle_name": "L.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "1-16-22904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.