Tavy Long

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-70948 Issued in CA

Practice address

3604-B Fair Oaks Blvd.
Suite 200
Sacramento, CA 95864

Phone

(855) 223-7123

NPI assigned

Aug 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1558843946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33568",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633568",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604-B FAIR OAKS BLVD.",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95864",
            "telephone_number": "855-223-7123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 2nd St Ste B",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945192623",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "TAVY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-57415",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-24-70948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Andrew Long, RN
• Kendall Long
• Lara Long
• Michele Etterbeek Long, M.D.
• Richelle Long, PH.D.
• Wen Long, MD
• Sara Longacre
• Eric Longenecker, RN
• Robert W Longenecker, CRNA
• Amber Lynn Longhitano

• Behavior Analyst in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.