Individual provider Active NPI

Savanah Sheriff

  • Behavior Analyst
  • Mesa, AZ
National Provider Identifier
1619589702
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
840 E McKellips Rd Ste 109
Mesa, AZ 85203-9654
Phone
(310) 493-1517
NPI assigned
Aug 19, 2020
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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 Primary

Addresses

Primary practice location

840 E McKellips Rd Ste 109
Mesa, AZ 85203-9654

Mailing address

840 E McKellips Rd Ste 109
Mesa, AZ 85203-9654
Phone (310) 493-1517

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Start Rescource Center LLC CurrentSince Aug 23, 2020 Accepting new patients
Fresh Start Center LLC CurrentSince Aug 28, 2022 Accepting new patients

Locations

840 E McKellips Rd
Ste 109
Mesa, AZ 85203
Phone (310) 493-1517

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1619589702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E MCKELLIPS RD STE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852039654",
            "telephone_number": "310-493-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E MCKELLIPS RD STE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852039654",
            "telephone_number": "310-493-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIFF",
        "first_name": "SAVANAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.