Active NPI
Shane Keola Noboru Okamoto, BCBA, MED
- Behavior Analyst
- Santa Clarita, CA
National Provider Identifier
1538949490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-62987
- Practice address
- 18257 Astro CT
Santa Clarita, CA 91350-3265 - Phone
- (661) 388-0357
- NPI assigned
- Sep 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-62987 | Primary |
Addresses
Primary practice location
18257 Astro CT
Santa Clarita, CA 91350-3265
Mailing address
18257 Astro CT
Santa Clarita, CA 91350-3265
Phone (661) 388-0357
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
- Credentials
- Master of Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1538949490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18257 ASTRO CT",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913503265",
"telephone_number": "661-388-0357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18257 ASTRO CT",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913503265",
"telephone_number": "661-388-0357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKAMOTO",
"first_name": "SHANE",
"middle_name": "KEOLA NOBORU",
"name_prefix": "Mr.",
"credential": "BCBA, MED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-28",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-22-62987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Clarita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.