Organization Active NPI

Ignite Innovative Behavioral Solutions

  • Behavior Analyst
  • Oakland, CA
National Provider Identifier
1750198636
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
IGNITE INNOVATIVE BEHAVIORAL SOLUTIONS
Practice address
811 York St Apt 121
Oakland, CA 94610-2107
Phone
(510) 696-6513
NPI assigned
Dec 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Authorized official

Name
Serena Richardson, BCBANPI 1376182717
Title
Ceo
Phone
(510) 696-6513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary
Community/Behavioral Health Agency 251S00000X
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

811 York St Apt 121
Oakland, CA 94610-2107

Mailing address

811 York St Apt 121
Oakland, CA 94610-2107
Phone (510) 696-6513

Other names 1

  • Empowered Path ABA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734134400000",
    "number": "1750198636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 YORK ST APT 121",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102107",
            "telephone_number": "510-696-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 YORK ST APT 121",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102107",
            "telephone_number": "510-696-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE INNOVATIVE BEHAVIORAL SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-14",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "SERENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-696-6513",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Empowered Path ABA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; 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.