Individual provider Active NPI

Miriam Luttbeg, BCABA

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1740520964
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0-05-1857 Issued in CA
Practice address
6540 Lusk Blvd
Suite C-157
San Diego, CA 92121-2767
Phone
(858) 678-0963
Fax
(858) 678-0964
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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 0-05-1857 CA Primary

Addresses

Primary practice location

6540 Lusk Blvd
Suite C-157
San Diego, CA 92121-2767

Mailing address

6167 Bristol Pkwy
Suite 130
Culver City, CA 90230-6610
Phone (310) 410-4450

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
Lovaas Institute for Early Intervention Behavior Analyst Past Accepting new patients
Lovaas Institute for Early Intervention Behavior Analyst Past 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": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1740520964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6167 BRISTOL PKWY",
            "address_2": "SUITE 130",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306610",
            "telephone_number": "310-410-4450",
            "fax_number": "310-410-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD",
            "address_2": "SUITE C-157",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212767",
            "telephone_number": "858-678-0963",
            "fax_number": "858-678-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTBEG",
        "first_name": "MIRIAM",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "0-05-1857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.