Individual provider Active NPI

Sara Lauren Gianino, M.S., B.C.B.A.

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1275684235
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-10-1782 Issued in FL
Practice address
13300 Atlantic Blvd Apt 823
Jacksonville, FL 32225-6114
Phone
(772) 480-5904
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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 1-10-1782 FL Primary

Addresses

Primary practice location

13300 Atlantic Blvd Apt 823
Jacksonville, FL 32225-6114

Mailing address

13300 Atlantic Blvd Apt 823
Jacksonville, FL 32225-6114
Phone (772) 480-5904

Other identifiers 1

IdentifierTypeStateIssuer
766647100MedicaidFL

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1275684235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 ATLANTIC BLVD APT 823",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256114",
            "telephone_number": "772-480-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 ATLANTIC BLVD APT 823",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256114",
            "telephone_number": "772-480-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANINO",
        "first_name": "SARA",
        "middle_name": "LAUREN",
        "credential": "M.S., B.C.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-10-1782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766647100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.