Kenneth Burg, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-25696 Issued in CA

Practice address

2115 W Crescent Ave
#224
Anaheim, CA 92801-3809

Phone

(714) 829-4138

NPI assigned

Apr 20, 2017

Last updated

Apr 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavior One Autism Solutions, LLC

  • Community/Behavioral Health Agency
  • Tustin, CA
  • NPI 1588143283
  NPD Authorized official

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1417481094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 W CRESCENT AVE",
            "address_2": "#224",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013809",
            "telephone_number": "714-829-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W CRESCENT AVE",
            "address_2": "#224",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013809",
            "telephone_number": "714-829-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURG",
        "first_name": "KENNETH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-17-25696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley Buonarigo
• Emily Burch
• Diane Jeanette Burd
• Kristina Erin Burdick, RADT-1
• Larry A Burfitt Jr., PTA
• Eric Burk, LMFT
• B Richard Burke, DPM FACFAS
• Jay Burke, LMFT
• Jean M. Burke, MD
• Katelyn Marie Burke

• Behavior Analyst in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.