Individual provider Active NPI

Alice Blair, MA BCBA

  • Behavior Analyst
  • Sacramento, CA
National Provider Identifier
1609332006
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-33596 Issued in CA
Practice address
9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone
(916) 363-6103
Fax
(916) 244-0594
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-18-33596 CA Primary

Addresses

Primary practice location

9755 Lincoln Village Dr
Sacramento, CA 95827-3334

Mailing address

9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone (916) 363-6103

Other practice location 1

2800 Stonecreek Dr
Sacramento, CA 95833-1634
Phone (916) 363-6103

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 Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Kids Behavior Analyst Past Accepting new patients
Advance Kids Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1609332006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9755 LINCOLN VILLAGE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273334",
            "telephone_number": "916-363-6103",
            "fax_number": "916-244-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9755 LINCOLN VILLAGE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273334",
            "telephone_number": "916-363-6103",
            "fax_number": "916-244-0594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Stonecreek Dr",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958331634",
            "country_code": "US",
            "telephone_number": "916-363-6103",
            "fax_number": "916-244-0594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "ALICE",
        "credential": "MA BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-18-33596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.