Active NPI
Juanita Traver Stine, BCBA
- Behavior Analyst
- Redwood City, CA
National Provider Identifier
1417353954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-14-16408
- Practice address
- 1155 Broadway St Ste 218
Redwood City, CA 94063-3127 - Phone
- (877) 264-6747
- Fax
- (877) 539-7730
- NPI assigned
- Nov 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-14-16408 | CA | Primary |
Addresses
Primary practice location
1155 Broadway St Ste 218
Redwood City, CA 94063-3127
Mailing address
1663 Mission St Ste 400
San Francisco, CA 94103-2485
Phone (877) 264-6747
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Behavior Analysis in Real Life LLC | Behavior Analyst | Current | Accepting new patients |
| Legacy Behavioral Collective, Inc. | Behavior Analyst | Current | Accepting new patients |
| Kyo Autism Therapy, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Behavior Analyst
- La Honda, CA
- NPI 1083542740
-
dba Gateway Learning Group, LLC
- Community/Behavioral Health Agency
- Daly City, CA
- NPI 1720212749
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417353954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1663 MISSION ST STE 400",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941032485",
"telephone_number": "877-264-6747",
"fax_number": "877-539-7730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 BROADWAY ST STE 218",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940633127",
"telephone_number": "877-264-6747",
"fax_number": "877-539-7730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVER STINE",
"first_name": "JUANITA",
"name_prefix": "Ms.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-14-16408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.