Individual provider Active NPI

Sehra Bae, M.S., BCBA

  • Behavior Analyst
  • Concord, CA
National Provider Identifier
1588029862
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-60583 Issued in CA
Practice address
1200 Concord Ave Ste 100
Concord, CA 94520-4969
Phone
(510) 268-8120
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X D8170671 CA
Behavior Analyst 103K00000X 1-22-60583 CA Primary

Addresses

Primary practice location

1200 Concord Ave Ste 100
Concord, CA 94520-4969

Mailing address

200 Cafaro Cir
Sacramento, CA 95834-1039
Phone (805) 298-2794

Other practice location 1

424 Peninsula Ave
San Mateo, CA 94401-1653
Phone (650) 286-4396

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 Science

State licenses

LicenseStateTypeSpecialty
D8170671CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Pivotal Learning Behavior Analyst Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1588029862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CAFARO CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341039",
            "telephone_number": "805-298-2794"
        },
        {
            "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": "424 Peninsula Ave",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944011653",
            "country_code": "US",
            "telephone_number": "650-286-4396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAE",
        "first_name": "SEHRA",
        "credential": "M.S., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "D8170671",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-22-60583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Aug 29, 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.