Active NPI
Sana Khan, MD, BCBA
- Behavior Analyst
- Stockton, CA
National Provider Identifier
1790292605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-28605
- Practice address
- 1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107 - Phone
- (510) 378-5432
- NPI assigned
- Jan 2, 2018
- Last updated
- May 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | 1-17-28605 | CA | |
| Behavior Analyst | 103K00000X | 1-17-28605 | CA | Primary |
Addresses
Primary practice location
1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107
Mailing address
35015 Fremont Blvd
Fremont, CA 94536-3340
Phone (510) 378-5432
Other practice location 1
35015 Fremont Blvd
Fremont, CA 94536-3340
Phone (510) 378-5432
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Red House Behavior Resources, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- San Francisco, CA
- NPI 1962838409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619913600000",
"number": "1790292605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35015 FREMONT BLVD",
"city": "FREMONT",
"state": "CA",
"postal_code": "945363340",
"telephone_number": "510-378-5432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 GRAND CANAL BLVD STE 2",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952078107",
"telephone_number": "510-378-5432"
}
],
"practiceLocations": [
{
"address_1": "35015 Fremont Blvd",
"address_purpose": "LOCATION",
"city": "Fremont",
"state": "CA",
"postal_code": "945363340",
"country_code": "US",
"telephone_number": "510-378-5432",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "SANA",
"name_prefix": "Dr.",
"credential": "MD, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-02",
"last_updated": "2021-05-02",
"certification_date": "2021-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "CA",
"license": "1-17-28605",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-17-28605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.