Individual provider Active NPI

Melissa Mora, MS, BCBA

  • Behavior Analyst
  • Rancho Cucamonga, CA
National Provider Identifier
1417328394
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11519467 Issued in CA
Practice address
8350 Archibald Ave Ste 125
Rancho Cucamonga, CA 91730-7701
Phone
(909) 689-4157
NPI assigned
Oct 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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 11519467 CA Primary

Addresses

Primary practice location

8350 Archibald Ave Ste 125
Rancho Cucamonga, CA 91730-7701

Mailing address

8350 Archibald Ave Ste 125
Rancho Cucamonga, CA 91730-7701
Phone (909) 689-4157

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11519467CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
BX Consultations Behavior Analyst CurrentSince Jun 30, 2024 Accepting new patients
Abs Psychology Services California Past Accepting new patients

Organizations & group practices 2

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": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1417328394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 ARCHIBALD AVE STE 125",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307701",
            "telephone_number": "909-689-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 ARCHIBALD AVE STE 125",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307701",
            "telephone_number": "909-689-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "MELISSA",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-16",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11519467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.