Individual provider Active NPI

Victoria Evana Ostergaard, BCBA

  • Behavior Analyst
  • Milwaukee, WI
National Provider Identifier
1659159960
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1141-140 Issued in WI
Practice address
1020 W Historic Mitchell St
Milwaukee, WI 53204-3307
Phone
(414) 567-0651
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 1141-140 WI Primary

Addresses

Primary practice location

1020 W Historic Mitchell St
Milwaukee, WI 53204-3307

Mailing address

225 Williamsburg Dr Apt 4
Thiensville, WI 53092-1646
Phone (414) 430-1492

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

State licenses

LicenseStateTypeSpecialty
1141-140WIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1659159960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSBURG DR APT 4",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530921646",
            "telephone_number": "414-430-1492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W HISTORIC MITCHELL ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043307",
            "telephone_number": "414-567-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERGAARD",
        "first_name": "VICTORIA",
        "middle_name": "EVANA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "1141-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.