MTN. Shadows Ancillary Services

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MTN. SHADOWS ANCILLARY SERVICES

Doing business as

Spectrum Solutions

Practice address

970 Los Vallecitos Blvd
Suite 140
San Marcos, CA 92069-1473

Phone

(760) 743-3714

NPI assigned

Nov 6, 2014

Organization subpart

No

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

Authorized official

Name

Arlene Galvan

Title

Program Director

Phone

(760) 743-3714

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Spectrum Solutions Doing business as

Locations

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1790181592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 LOS VALLECITOS BLVD",
            "address_2": "SUITE 240",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691473",
            "telephone_number": "760-743-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LOS VALLECITOS BLVD",
            "address_2": "SUITE 140",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691473",
            "telephone_number": "760-743-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTN. SHADOWS ANCILLARY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "GALVAN",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "760-743-3714"
    },
    "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "BL12021639",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colin Andrew Moulton, PT, DPT
• Mountain Shadows Support Group
• Mountain Shadows Support Group, Inc.
• Mountain Shadows Support Group, Inc.
• Victor Mozo
• Vivian Mui
• Taylor Mulcahy
• Mulvey Chiropractic, Inc.
• Finbarr Martin Mulvey, D.C.
• Sujatha Murali, MD

• Behavior Analyst in San Marcos, CA
• Providers in San Marcos, 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 13, 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.

Verify at the official NPI Registry.