Active NPI
Cattuong Phan, BCBA
- Behavior Analyst
- Santa Ana, CA
National Provider Identifier
1679004352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-16-23909
- Practice address
- 2080 N Tustin Ave
Suite B
Santa Ana, CA 92705-7875 - Phone
- (855) 581-0100
- Fax
- (949) 709-0311
- NPI assigned
- Mar 23, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 1-16-23909 | CA | Primary |
Addresses
Primary practice location
2080 N Tustin Ave
Suite B
Santa Ana, CA 92705-7875
Mailing address
2080 N Tustin Ave
Suite B
Santa Ana, CA 92705-7875
Phone (855) 581-0100
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490227200000",
"number": "1679004352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2080 N TUSTIN AVE",
"address_2": "SUITE B",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927057875",
"telephone_number": "855-581-0100",
"fax_number": "949-709-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 N TUSTIN AVE",
"address_2": "SUITE B",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927057875",
"telephone_number": "855-581-0100",
"fax_number": "949-709-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "CATTUONG",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2017-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-16-23909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.