Gordon Peng

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

17752 Sky Park Cir Ste 140
Irvine, CA 92614-4469

Phone

(949) 474-5577

Fax

(949) 474-5575

NPI assigned

Oct 31, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Autism Spectrum Consultants

  • Developmentally Disabled Services Day Training Agency
  • Irvine, CA
  • NPI 1306167994
  NPD (past)

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1740053883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 PASEO CIRCULO",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829012",
            "telephone_number": "714-280-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17752 SKY PARK CIR STE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926144469",
            "telephone_number": "949-474-5577",
            "fax_number": "949-474-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "GORDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bsanchez@ascaba.com",
            "affiliation": "N",
            "endpointDescription": "Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17752 Sky Park Cir Ste 140",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926144469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Joseph Pena, LMFT
• Brittany Marie Penaloza
• Tracy Pene, DDS
• Peng-Yun Angela Huang, M.D., a Professional Corporation
• Christine Peng, M.D.
• Achaia Penn
• Whitney Penner
• Jackson B Penney
• Janet E Penny-Cook
• Stephanie Penuela

• Behavior Technician in Irvine, CA
• Providers in Irvine, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.