NPIMap

Organization Active NPI

Institute for Applied Behavior Analysis

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1487920054
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY5115 Issued in CA
Legal business name
INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS
Practice address
5777 W Century Blvd Ste 675
Los Angeles, CA 90045-5632
Phone
(310) 649-0499
NPI assigned
Mar 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Sara Elizabeth Black
Title
Ceo
Phone
(310) 649-0499

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-02-0940 CA
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-01-0612 CA
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-09-6511 CA
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-11-7967 CA
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-11-8158 CA
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY5115 CA Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X PSY24318 CA

Addresses

Primary practice location

5777 W Century Blvd Ste 675
Los Angeles, CA 90045-5632

Mailing address

5777 W Century Blvd Ste 675
Los Angeles, CA 90045-5632
Phone (310) 649-0499

Other practice location 1

14148 Magnolia Blvd Ste 103
Sherman Oaks, CA 91423-6414
Phone (818) 489-0866

National Provider Directory

National Provider Directory
Tax ID family
Institute for Applied Behavior Analysis3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5777 W Century Blvd
Ste 675
Los Angeles, CA 90045
Phone (310) 649-0499

14148 Magnolia Blvd
Ste 103
Sherman Oaks, CA 91423
Phone (310) 649-0499

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1487920054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD STE 675",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-649-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD STE 675",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-649-0499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14148 Magnolia Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914236414",
            "country_code": "US",
            "telephone_number": "818-489-0866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-649-0499"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-02-0940",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-01-0612",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-09-6511",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-11-7967",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-11-8158",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY5115",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY24318",
            "primary": false
        }
    ],
    "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 Mar 31, 2021; 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.