Imagine Behavioral Services Ca, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

IMAGINE BEHAVIORAL SERVICES CA, LLC

Practice address

19300 S Hamilton Ave
#130
Gardena, CA 90248-4400

Phone

(310) 327-7842

NPI assigned

Feb 24, 2015

Organization subpart

No

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

Authorized official

Name

Quinanna Robins

Title

VP of Autism & Behavioral Services

Phone

(509) 328-2740

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1821480013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5709 W SUNSET HWY",
            "address_2": "SUITE 100",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992246005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19300 S HAMILTON AVE",
            "address_2": "#130",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484400",
            "telephone_number": "310-327-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE BEHAVIORAL SERVICES CA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "ROBINS",
        "authorized_official_first_name": "QUINANNA",
        "authorized_official_title_or_position": "VP OF AUTISM & BEHAVIORAL SERVICES",
        "authorized_official_telephone_number": "509-328-2740"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Gardena, CA
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• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.