Active NPI
Nicole Zawoysky
- Behavior Analyst
- Concord, CA
National Provider Identifier
1558862839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-45939
- Practice address
- 1200 Concord Ave Ste 100
Concord, CA 94520-4969 - Phone
- (510) 268-8120
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-29119 | CA | |
| Behavior Analyst | 103K00000X | 1-20-45939 | Primary |
Addresses
Primary practice location
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Mailing address
803 Clina Way
Roseville, CA 95661-4610
Phone (661) 400-3021
Other practice location 1
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Phone (510) 268-8120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-20-45939 | Other | BEHAVIOR ANALYST CERTIFICATION BOARD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://csdautismservices.com/ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-29119 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1558862839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 CLINA WAY",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614610",
"telephone_number": "661-400-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CONCORD AVE STE 100",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204969",
"telephone_number": "510-268-8120"
}
],
"practiceLocations": [
{
"address_1": "1200 Concord Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "CA",
"postal_code": "945204969",
"country_code": "US",
"telephone_number": "510-268-8120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZAWOYSKY",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-17-29119",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-20-45939",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
"identifier": "1-20-45939",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://csdautismservices.com/",
"affiliation": "N",
"address_1": "1200 Concord Ave Ste 100",
"city": "Concord",
"state": "CA",
"country_code": "US",
"postal_code": "945204969",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.