Amy Smith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-36068 Issued in CA

Practice address

22968 Via Nuez
Mission Viejo, CA 92691-5326

Phone

(714) 931-5908

NPI assigned

Jul 9, 2019

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

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.

• Lively Behavioral Solutions LLC

  • Behavior Analyst
  • Huntington Beach, CA
  • NPI 1255062147
  NPD

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1477105609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22968 VIA NUEZ",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22968 VIA NUEZ",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915326",
            "telephone_number": "714-931-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-36068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Mignon Sisneros, PA-C
• David Edward Skonezny, CADC-II, ICADC
• Helen Slama
• Smith-Teitelbaum Chiropractic Inc. (Teitelbaum Chiropractic, Inc.)
• Amber Smith, MS, RD
• Kelly Smith, O.T.
• Melanie A Smith, CLEC
• Sarah Smith
• Wilbur I Smith
• Linda Snell

• Behavior Analyst in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.