Bob Kabamba, SKA-SHIFRA HOME

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7136 N 73Rd Dr
Gendale, AZ 85303

Phone

(623) 435-3976

NPI assigned

Jul 13, 2017

Last updated

Jul 13, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ska Shifra Home Other name

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.

• Ska-Shifra Facility

  • Mental Illness Community Based Residential Treatment Facility
  • Glendale, AZ
  • NPI 1861932097
  NPD (past) Authorized official
• Ska-Shifra LLC

  • Community/Behavioral Health Agency
  • Goodyear, AZ
  • NPI 1194316802
  NPD (past) Authorized official

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1447772264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 N 73RD DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853032569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 N 73RD DR",
            "city": "GENDALE",
            "state": "AZ",
            "postal_code": "85303",
            "telephone_number": "623-435-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABAMBA",
        "first_name": "BOB",
        "credential": "SKA-SHIFRA HOME",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SKA",
            "last_name": "SHIFRA HOME",
            "credential": "SKA-SHIFRA HOME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.