Individual provider Active NPI

Vittorio Matinata, PSY.D., BCBA

  • Behavior Analyst
  • Woodland Hills, CA
National Provider Identifier
1679990345
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB 1-11-8111 Issued in CA
Practice address
22055 Clarendon St Ste 208
Woodland Hills, CA 91367-6354
Phone
(818) 932-9644
Fax
(818) 932-8997
NPI assigned
Mar 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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 BACB 1-11-8111 CA Primary

Addresses

Primary practice location

22055 Clarendon St Ste 208
Woodland Hills, CA 91367-6354

Mailing address

22055 Clarendon St Ste 208
Woodland Hills, CA 91367-6354
Phone (818) 932-9644

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
Creative Behavioral Consultants, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1679990345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22055 CLARENDON ST STE 208",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676354",
            "telephone_number": "818-932-9644",
            "fax_number": "818-932-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22055 CLARENDON ST STE 208",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676354",
            "telephone_number": "818-932-9644",
            "fax_number": "818-932-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATINATA",
        "first_name": "VITTORIO",
        "name_prefix": "Dr.",
        "credential": "PSY.D., BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "BACB 1-11-8111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.