Active NPI
Madelyne Guadalupe Guevara
- Behavior Analyst
- Los Angeles, CA
National Provider Identifier
1417678343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1602 W Olympic Boulevard
Los Angeles, CA 90015 - Phone
- (323) 433-4165
- NPI assigned
- Sep 8, 2022
- 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 | Primary |
Addresses
Primary practice location
1602 W Olympic Boulevard
Los Angeles, CA 90015
Mailing address
12119 S Normandie Ave
Los Angeles, CA 90044-1148
Phone (132) 349-6005
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1417678343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12119 S NORMANDIE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900441148",
"telephone_number": "132-349-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1602 W OLYMPIC BOULEVARD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90015",
"telephone_number": "323-433-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEVARA",
"first_name": "MADELYNE",
"middle_name": "GUADALUPE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2022-09-08",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.