Square Peg Foundation

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BCBA 1-14-15647 Issued in CA

Legal business name

SQUARE PEG FOUNDATION

Practice address

12150 San Mateo Rd
Half Moon Bay, CA 94019-7108

Phone

(650) 440-5064

NPI assigned

Jul 12, 2016

Organization subpart

No

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

Authorized official

Name

Joell Marie Dunlap, RBT

Title

Executive Director

Phone

(650) 440-5064

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1609228840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 CABRILLO HWY N STE Q",
            "address_2": "PMB 402",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191698",
            "telephone_number": "650-440-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 SAN MATEO RD",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940197108",
            "telephone_number": "650-440-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUARE PEG FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "JOELL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "650-440-5064",
        "authorized_official_credential": "RBT"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "BCBA 1-14-15647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Senffner, MA, PT
• Brian D Sheppard
• Laura Siniego, MFT
• Jonathan Adam Slusher
• Sonrisas Dental Health, Inc
• Elizabeth Squiers, M.D.
• Mary Kathryn Stadler, LMFT
• Treacy Sterling, PHARMD
• Lorie Ann Stevens, MFTI
• Sun Center for Well Being

• Behavior Analyst in Half Moon Bay, CA
• Providers in Half Moon Bay, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.