Individual provider Active NPI

Angela Moore, BCBA

  • Behavior Analyst
  • San Jose, CA
National Provider Identifier
1699148346
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11519719 Issued in CA
Practice address
1530 Meridian Ave Ste 302
San Jose, CA 95125-5350
Phone
(628) 250-7500
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 11519719 CA Primary

Addresses

Primary practice location

1530 Meridian Ave Ste 302
San Jose, CA 95125-5350

Mailing address

1530 Meridian Ave Ste 302
San Jose, CA 95125-5350

Other names 1

  • Angela Cooper Former name

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
11519719CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise ABA LLC Behavior Analyst PastSince Mar 20, 2025 Accepting new patients
Sunrise ABA of Kentucky ,LLC Behavior Analyst PastSince Mar 20, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1699148346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 MERIDIAN AVE STE 302",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 MERIDIAN AVE STE 302",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255350",
            "telephone_number": "628-250-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11519719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "COOPER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.