Beachmont Behavioral Health, Inc

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BEACHMONT BEHAVIORAL HEALTH, INC

Practice address

701 E Santa Clara St # V-16
Ventura, CA 93001-5972

Phone

(805) 585-0165

NPI assigned

Nov 25, 2024

Organization subpart

No

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

Authorized official

Name

Jeremy Wilson, PHD, BCBA-DNPI 1821357716

Title

Ceo/President/Secretary

Phone

(805) 585-0165

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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.

• Jeremy Wilson, PHD, BCBA-D

  • Behavior Analyst
  • Ventura, CA
  • NPI 1821357716
  NPD Authorized official

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1770309643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E SANTA CLARA ST # V-16",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930015972",
            "telephone_number": "805-585-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E SANTA CLARA ST # V-16",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930015972",
            "telephone_number": "805-585-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHMONT BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CEO/PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "805-585-0165",
        "authorized_official_credential": "PHD, BCBA-D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "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": []
}

• Krystale Bautista
• Mari Claire Bautista, BA
• Sara Bavar
• Corinne Yvonne Baxter, LMFT
• Constina Baylor, AMFT
• Beachside Adult and Family Therapy Inc
• Marc A Beaghler, M.D.
• Brittany Beard
• Amber Nicole Beasley, MSW
• Rene J Beauchesne, LCSW

• Behavior Analyst in Ventura, CA
• Providers in Ventura, CA by specialty
• Behavior Analyst in California

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