Individual provider Active NPI

Tara Ordway, MA, BCBA

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1750898375
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-30928 Issued in CA
Practice address
5075 Shoreham PL Ste 115
San Diego, CA 92122-5927
Phone
(858) 272-2662
NPI assigned
Jan 4, 2018
Reactivated
May 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 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 1-18-30928 CA Primary

Addresses

Primary practice location

5075 Shoreham PL Ste 115
San Diego, CA 92122-5927

Mailing address

5075 Shoreham PL Ste 115
San Diego, CA 92122-5927
Phone (858) 272-2662

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1750898375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 SHOREHAM PL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225927",
            "telephone_number": "858-272-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 SHOREHAM PL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225927",
            "telephone_number": "858-272-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDWAY",
        "first_name": "TARA",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "deactivation_date": "2025-03-14",
        "reactivation_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-18-30928",
            "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 May 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.