Individual provider Active NPI

Cristian Gandara

  • Behavior Analyst
  • Pico Rivera, CA
National Provider Identifier
1376900340
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-20678 Issued in CA
Practice address
9625 Lochinvar Dr
Pico Rivera, CA 90660
Phone
(323) 828-9551
Fax
(323) 978-6035
NPI assigned
Jan 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2018

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 1-15-20678 CA Primary

Addresses

Primary practice location

9625 Lochinvar Dr
Pico Rivera, CA 90660

Mailing address

9625 Lochinvar Dr
Pico Rivera, CA 90660-3935
Phone (323) 828-9551

Other practice location 1

713 W Commonwealth Ave
A
Fullerton, CA 92832-1612
Phone (714) 879-4274 ext. 87942

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Spectrum Therapies Behavior Analyst Current Accepting new patients

Organizations & group practices 1

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": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1376900340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 LOCHINVAR DR",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906603935",
            "telephone_number": "323-828-9551",
            "fax_number": "323-978-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 LOCHINVAR DR",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "90660",
            "telephone_number": "323-828-9551",
            "fax_number": "323-978-6035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "713 W Commonwealth Ave",
            "address_2": "A",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928321612",
            "country_code": "US",
            "telephone_number": "714-879-4274 x87942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDARA",
        "first_name": "CRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-21",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-15-20678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.