Individual provider Active NPI

Heidi Glesne Montague, BCBA

  • Behavior Analyst
  • Torrance, CA
National Provider Identifier
1821355306
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-07-3529 Issued in CA
Practice address
2909 Oregon CT
A1
Torrance, CA 90503-2645
Phone
(310) 320-1333
NPI assigned
Apr 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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 1-07-3529 CA Primary

Addresses

Primary practice location

2909 Oregon CT
A1
Torrance, CA 90503-2645

Mailing address

2909 Oregon CT
A1
Torrance, CA 90503-2645
Phone (310) 320-1333

Other identifiers 1

IdentifierTypeStateIssuer
1-07-3529OtherCABCBA

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

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1821355306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 OREGON CT",
            "address_2": "A1",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905032645",
            "telephone_number": "310-320-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 OREGON CT",
            "address_2": "A1",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905032645",
            "telephone_number": "310-320-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "HEIDI",
        "middle_name": "GLESNE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-07-3529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA",
            "identifier": "1-07-3529",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.