NPIMap

Organization Active NPI

Progressive Behavior Services

  • Developmental - Behavioral Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1578299897
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
PROGRESSIVE BEHAVIOR SERVICES
Practice address
3065 Rosecrans PL Ste 200
San Diego, CA 92110-4822
Phone
(714) 943-7146
NPI assigned
Jul 28, 2022
Last updated
Jul 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Shawn Manvell, PRESIDENT,OWNER, SLP
Title
Owner and SLP
Phone
(714) 943-7146

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X NU Primary
Behavior Analyst 103K00000X NU
Assistant Behavior Analyst 106E00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

3065 Rosecrans PL Ste 200
San Diego, CA 92110-4822

Mailing address

3065 Rosecrans PL Ste 200
San Diego, CA 92110-4822
Phone (714) 943-7146

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1578299897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 ROSECRANS PL STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104822",
            "telephone_number": "714-943-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 ROSECRANS PL STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104822",
            "telephone_number": "714-943-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "MANVELL",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER AND SLP",
        "authorized_official_telephone_number": "714-943-7146",
        "authorized_official_credential": "PRESIDENT,OWNER, SLP"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.