NPIMap

Organization Active NPI

Pediatric Minds Developmental Services, Inc.

Doing business as Pediatric Minds Developmental Services

  • Behavior Analyst
  • Torrance, CA
National Provider Identifier
1376803742
Registry record updated May 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PEDIATRIC MINDS DEVELOPMENTAL SERVICES, INC.
Doing business as
Pediatric Minds Developmental Services
Practice address
3524 Torrance Blvd Ste 104
Torrance, CA 90503-4821
Phone
(310) 540-1630
Fax
(310) 540-1610
NPI assigned
May 20, 2012
Last updated
May 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2012

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

Authorized official

Name
Dr. Pantea Sharifi Hannauer, MD
Title
Owner
Phone
(310) 540-1630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

3524 Torrance Blvd Ste 104
Torrance, CA 90503-4821

Mailing address

3524 Torrance Blvd Ste 104
Torrance, CA 90503-4821
Phone (310) 540-1630

Other names 1

  • Pediatric Minds Developmental Services Doing business as

National Provider Directory

National Provider Directory

Locations

3524 Torrance Blvd
Ste 104
Torrance, CA 90503
Phone (310) 540-1630

3524 Torrance Blvd
Ste 105
Torrance, CA 90503
Phone (310) 540-1655

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337472000000",
    "number": "1376803742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 TORRANCE BLVD STE 104",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034821",
            "telephone_number": "310-540-1630",
            "fax_number": "310-540-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 TORRANCE BLVD STE 104",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034821",
            "telephone_number": "310-540-1630",
            "fax_number": "310-540-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MINDS DEVELOPMENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-20",
        "last_updated": "2012-05-20",
        "status": "A",
        "authorized_official_last_name": "HANNAUER",
        "authorized_official_first_name": "PANTEA",
        "authorized_official_middle_name": "SHARIFI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-540-1630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Minds Developmental Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2012; 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.