Organization Active NPI

Guiding Light Behavioral Therapies LLC

  • Behavior Analyst
  • Los Angeles, CA
National Provider Identifier
1487090403
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-8356 Issued in CA
Legal business name
GUIDING LIGHT BEHAVIORAL THERAPIES LLC
Practice address
4259 Walton Ave
Los Angeles, CA 90037-2427
Phone
(424) 209-9032
NPI assigned
May 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Marai Fuller
Title
Ceo
Phone
(424) 209-9032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-11-8356 CA Primary

Addresses

Primary practice location

4259 Walton Ave
Los Angeles, CA 90037-2427

Mailing address

4259 Walton Ave
Los Angeles, CA 90037-2427

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1487090403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4259 WALTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4259 WALTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372427",
            "telephone_number": "424-209-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDING LIGHT BEHAVIORAL THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "MARAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-209-9032"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-11-8356",
            "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 May 16, 2013; 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.