Individual provider Active NPI

Melissa Christine McEvoy, BCBA

  • Behavior Analyst
  • Walnut Creek, CA
National Provider Identifier
1366082299
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-53310 Issued in CA
Practice address
1910 Olympic Blvd Ste 140&150
Walnut Creek, CA 94596-5096
Phone
(925) 433-0990
NPI assigned
Jan 8, 2020
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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 1-21-53310 CA Primary

Addresses

Primary practice location

1910 Olympic Blvd Ste 140&150
Walnut Creek, CA 94596-5096

Mailing address

2100 Pacheco St Apt 314
Concord, CA 94520-2364
Phone (559) 274-2795

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

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1366082299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PACHECO ST APT 314",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202364",
            "telephone_number": "559-274-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 OLYMPIC BLVD STE 140&150",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965096",
            "telephone_number": "925-433-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEVOY",
        "first_name": "MELISSA",
        "middle_name": "CHRISTINE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-21-53310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.