Individual provider Active NPI

Marylou Rose Barayuga, BCBA

  • Behavior Analyst
  • Long Beach, CA
National Provider Identifier
1457917288
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11833702 Issued in CA
Practice address
444 W Ocean Blvd Ste 800
Long Beach, CA 90802-4529
Phone
(888) 286-8715
NPI assigned
May 16, 2019
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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 11833702 CA Primary

Addresses

Primary practice location

444 W Ocean Blvd Ste 800
Long Beach, CA 90802-4529

Mailing address

100 Termino Ave Apt 2
Long Beach, CA 90803-2833
Phone (805) 512-6459

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

State licenses

LicenseStateTypeSpecialty
11833702CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1457917288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TERMINO AVE APT 2",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032833",
            "telephone_number": "805-512-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W OCEAN BLVD STE 800",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024529",
            "telephone_number": "888-286-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAYUGA",
        "first_name": "MARYLOU",
        "middle_name": "ROSE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11833702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.