Individual provider Active NPI

Lance Havens, BCBA

  • Behavior Analyst
  • Oceanside, CA
National Provider Identifier
1275069726
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-21047 Issued in CA
Practice address
1759 Oceanside Blvd Ste C118
Oceanside, CA 92054-3470
Phone
(213) 915-8277
Fax
(844) 609-0034
NPI assigned
May 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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 1-15-21047 CA Primary

Addresses

Primary practice location

1759 Oceanside Blvd Ste C118
Oceanside, CA 92054-3470

Mailing address

1759 Oceanside Blvd Ste C118
Oceanside, CA 92054-3470
Phone (213) 915-8277

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aim Behavior Services, LLC Behavior Analyst CurrentSince Nov 8, 2020 Accepting new patients

Locations

1759 Oceanside Blvd
Ste C118
Oceanside, CA 92054
Phone (213) 915-8277

3604 Ocean Ranch Blvd
Oceanside, CA 92056
Phone (213) 915-8277

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.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1275069726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1759 OCEANSIDE BLVD STE C118",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920543470",
            "telephone_number": "213-915-8277",
            "fax_number": "844-609-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 OCEANSIDE BLVD STE C118",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920543470",
            "telephone_number": "213-915-8277",
            "fax_number": "844-609-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "LANCE",
        "name_prefix": "Mr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-15-21047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.