Individual provider Active NPI

Neil David Miranda, MED

  • Behavior Analyst
  • Huntington Beach, CA
National Provider Identifier
1336796515
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-23149 Issued in CA
Practice address
4952 Warner Ave Ste 300
Huntington Beach, CA 92649-5506
Phone
(714) 351-3709
NPI assigned
Aug 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 2132 NC
Behavior Analyst 103K00000X 1-16-23149 CA Primary

Addresses

Primary practice location

4952 Warner Ave Ste 300
Huntington Beach, CA 92649-5506

Mailing address

26322 Towne Centre Dr Apt 1521
Foothill Ranch, CA 92610-3407

Other practice location 1

910 E Main St
Lincolnton, NC 28092-3449
Phone (704) 748-0616

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 Education

State licenses

LicenseStateTypeSpecialty
2132NCMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Rehabilitation and Sports Physical Therapy, PC Past Accepting new patients
Comprehab LLC Behavior Analyst Past Accepting new patients
ABA Enhancement Behavior Analyst Past Accepting new patients

Organizations & group practices 3

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": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1336796515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26322 TOWNE CENTRE DR APT 1521",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926103407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4952 WARNER AVE STE 300",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926495506",
            "telephone_number": "714-351-3709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Main St",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280923449",
            "country_code": "US",
            "telephone_number": "704-748-0616",
            "fax_number": "704-240-9980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "NEIL",
        "middle_name": "DAVID",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "2132",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-16-23149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.