Individual provider Active NPI

Sophida Chechang Simmons, BEHAVIOR ANALYST

  • Behavior Analyst
  • San Bernardino, CA
National Provider Identifier
1366969214
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
B6856860 Issued in CA
Practice address
1905 Business Center Dr Ste 100
San Bernardino, CA 92408-3460
Phone
(909) 435-0212
NPI assigned
Aug 22, 2017
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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 B6856860 CA Primary

Addresses

Primary practice location

1905 Business Center Dr Ste 100
San Bernardino, CA 92408-3460

Mailing address

36093 Leeds St
Winchester, CA 92596-9176
Phone (909) 856-4014

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

State licenses

LicenseStateTypeSpecialty
B6856860CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1366969214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36093 LEEDS ST",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925969176",
            "telephone_number": "909-856-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BUSINESS CENTER DR STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083460",
            "telephone_number": "909-435-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "SOPHIDA",
        "middle_name": "CHECHANG",
        "name_prefix": "Mrs.",
        "credential": "BEHAVIOR ANALYST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "B6856860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.