NPIMap

Organization Active NPI

Innovate ABA

  • Behavior Analyst
  • Irvine, CA
National Provider Identifier
1346863529
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
INNOVATE ABA
Practice address
5405 Alton Pkwy Ste 5a
#430
Irvine, CA 92604-3717
Phone
(714) 580-5969
NPI assigned
May 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Authorized official

Name
Ms. Brooke Tawanna, MS, BCBANPI 1336483056
Title
Owner
Phone
(714) 580-5969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

5405 Alton Pkwy Ste 5a
#430
Irvine, CA 92604-3717

Mailing address

5405 Alton Pkwy Ste 5a
#430
Irvine, CA 92604-3717

National Provider Directory

National Provider Directory

Locations

5405 Alton Pkwy
Ste 5A
Irvine, CA 92604
Phone (714) 580-5969

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1346863529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 ALTON PKWY STE 5A",
            "address_2": "#430",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 ALTON PKWY STE 5A",
            "address_2": "#430",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043717",
            "telephone_number": "714-580-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATE ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "TAWANNA",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-580-5969",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.