Jacqueline Sue Tanaka, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-07-2355 Issued in CO

Practice address

5912 Mapleton Dr
Colorado Springs, CO 80918-5679

Phone

(719) 233-5680

NPI assigned

Sep 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1386893402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 MAPLETON DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185679",
            "telephone_number": "719-233-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5912 MAPLETON DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185679",
            "telephone_number": "719-233-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7312 Bonnie Brae Ln",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809223151",
            "country_code": "US",
            "telephone_number": "719-233-5680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "JACQUELINE",
        "middle_name": "SUE",
        "credential": "BCABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CO",
            "license": "0-07-2355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Walker Tan, MD
• Percivil Tan, LPC
• Sarah N Tan, MA, LPC
• Robert M Tanabe, MD
• Chanda Tanaka, BSN, RN
• Daniel James Tandberg, M.D.
• Jace Noel Tande
• Shelley Tanen, LCSW
• Tangled Sage LLC
• Andrew Scott Tanner, MD

• Assistant Behavior Analyst in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Assistant Behavior Analyst in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.