NPIMap

Organization Active NPI

Creative Behavior Interventions

  • Behavior Analyst
  • Tustin, CA
National Provider Identifier
1750650933
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-07-3777 Issued in CA
Legal business name
CREATIVE BEHAVIOR INTERVENTIONS
Practice address
3002 Dow Ave
Suite 520
Tustin, CA 92780-7233
Phone
(949) 861-1580
Fax
(949) 328-7689
NPI assigned
Dec 19, 2011
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Dr. Denise Marie Eckman, PSY.D., BCBA-DNPI 1598117590
Title
President
Phone
(949) 861-1580

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: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-07-3777 CA Primary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X PSY22024 CA
Developmentally Disabled Services Day Training Agency 251C00000X 1-07-3777 CA

Addresses

Primary practice location

3002 Dow Ave
Suite 520
Tustin, CA 92780-7233

Mailing address

3002 Dow Ave
Suite 520
Tustin, CA 92780-7233
Phone (949) 861-1580

National Provider Directory

National Provider Directory

Locations

3002 Dow Ave
Ste 122
Tustin, CA 92780
Phone (949) 328-7688

3002 Dow Ave
Ste 520
Tustin, CA 92780
Phone (949) 861-1580

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1750650933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 DOW AVE",
            "address_2": "SUITE 520",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807233",
            "telephone_number": "949-861-1580",
            "fax_number": "949-328-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 DOW AVE",
            "address_2": "SUITE 520",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807233",
            "telephone_number": "949-861-1580",
            "fax_number": "949-328-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE BEHAVIOR INTERVENTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "ECKMAN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-861-1580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., BCBA-D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-07-3777",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY22024",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "CA",
            "license": "1-07-3777",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.