Active NPI
Jenna Shaw, M.S., BCBA
- Behavior Analyst
- Vacaville, CA
National Provider Identifier
1336673482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 183 Butcher Rd
Suite B
Vacaville, CA 95687-5690 - Phone
- (209) 923-3323
- NPI assigned
- Apr 15, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
183 Butcher Rd
Suite B
Vacaville, CA 95687-5690
Mailing address
1801 L St
Apartment 405
Sacramento, CA 95811-4110
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PJD Enterprises LLC | Behavior Analyst | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492214400000",
"number": "1336673482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 L ST",
"address_2": "APARTMENT 405",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958114110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 BUTCHER RD",
"address_2": "SUITE B",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956875690",
"telephone_number": "209-923-3323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JENNA",
"credential": "M.S., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-15",
"last_updated": "2017-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.