Active NPI
Dustin Espinoza
- Behavior Analyst
- Hayward, CA
National Provider Identifier
1477023927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11940019
- Practice address
- 22320 Foothill Blvd Ste 230
Hayward, CA 94541-2721 - Phone
- (888) 428-3223
- Fax
- (323) 866-1881
- NPI assigned
- Nov 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 11940019 | CA | Primary |
Addresses
Primary practice location
22320 Foothill Blvd Ste 230
Hayward, CA 94541-2721
Mailing address
4221 Wilshire Blvd Ste 300a
Los Angeles, CA 90010-3537
Phone (888) 428-3223
Other practice location 1
2010 N 1st St Ste 402
San Jose, CA 95131-2039
Phone (888) 428-3223
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11940019 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intercare Therapy Inc. | Current | Accepting new patients |
Locations
4221 Wilshire Blvd
Ste 300A
Los Angeles, CA 90010
Phone (323) 556-3048
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1164065892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581379200000",
"number": "1477023927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4221 WILSHIRE BLVD STE 300A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103537",
"telephone_number": "888-428-3223",
"fax_number": "323-866-1881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22320 FOOTHILL BLVD STE 230",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945412721",
"telephone_number": "888-428-3223",
"fax_number": "323-866-1881"
}
],
"practiceLocations": [
{
"address_1": "2010 N 1st St Ste 402",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951312039",
"country_code": "US",
"telephone_number": "888-428-3223",
"fax_number": "323-866-1881",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESPINOZA",
"first_name": "DUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-27",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "11940019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.