Individual provider Active NPI

Joseph Vallejos, BCBA

  • Behavior Analyst
  • Fresno, CA
National Provider Identifier
1376907295
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-21853 Issued in CA
Practice address
1630 E Shaw Ave
Ste. 190
Fresno, CA 93710-8105
Phone
(559) 475-7860
Fax
(559) 475-7862
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 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 1-16-21853 CA Primary

Addresses

Primary practice location

1630 E Shaw Ave
Ste. 190
Fresno, CA 93710-8105

Mailing address

PO Box 25042
Fresno, CA 93729-5042
Phone (559) 475-7860

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
California Autism Center, Inc. Behavior Analyst Past 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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1376907295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25042",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937295042",
            "telephone_number": "559-475-7860",
            "fax_number": "559-475-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E SHAW AVE",
            "address_2": "STE. 190",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108105",
            "telephone_number": "559-475-7860",
            "fax_number": "559-475-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJOS",
        "first_name": "JOSEPH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-16-21853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.