Active NPI
Sarah Conklin, BCBA
- Behavior Analyst
- Los Angeles, CA
National Provider Identifier
1669868980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11417703
- Practice address
- 2072 Dracena Dr
Los Angeles, CA 90027-2605 - Phone
- (818) 296-7282
- Fax
- (323) 426-9470
- NPI assigned
- Apr 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11417703 | CA | Primary |
Addresses
Primary practice location
2072 Dracena Dr
Los Angeles, CA 90027-2605
Mailing address
2072 Dracena Dr
Los Angeles, CA 90027-2605
Phone (818) 296-7282
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11417703 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Behavior Analysis | 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.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1780134585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1669868980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2072 DRACENA DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900272605",
"telephone_number": "818-296-7282",
"fax_number": "323-426-9470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2072 DRACENA DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900272605",
"telephone_number": "818-296-7282",
"fax_number": "323-426-9470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "SARAH",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-14",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "11417703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.