Active NPI
Makoto Shibutani
- Behavior Analyst
- Victorville, CA
National Provider Identifier
1760887103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 13901 Amargosa Rd
Victorville, CA 92392-2409 - Phone
- (760) 512-1925
- NPI assigned
- Oct 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
13901 Amargosa Rd
Victorville, CA 92392-2409
Mailing address
13920 City Center Dr Ste 290
Chino Hills, CA 91709-5444
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoples Care Autism Services | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Victorville, CA
- NPI 1093057978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414454400000",
"number": "1760887103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13920 CITY CENTER DR STE 290",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917095444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13901 AMARGOSA RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923922409",
"telephone_number": "760-512-1925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIBUTANI",
"first_name": "MAKOTO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-28",
"last_updated": "2014-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
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- Sheila M. Bartlett a Professional Corporation (Advanced Optometric Eyecare)
- Shelton Family Therapy, Inc.
- Julie Shen, DDS
- Sherylann Wade, M.D., Inc.
- Shiloh Medical Center Inc
- Shima Hadidchi MD a Professional Corp
- Shima Hadidchi MD a Professional Corp
- Amanda Shin, DPT
- Andrew Woochul Shin, D.D.S
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.