NPIMap

Individual provider Active NPI

Marian Alice Woodside, BCBA

  • Behavior Analyst
  • Alameda, CA
National Provider Identifier
1821480229
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11417851
Practice address
1025 Atlantic Ave
Suite 101
Alameda, CA 94501-1188
Phone
(510) 268-8120
NPI assigned
Feb 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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 11417851 Primary

Addresses

Primary practice location

1025 Atlantic Ave
Suite 101
Alameda, CA 94501-1188

Mailing address

1200 Concord Ave
Suite 100
Concord, CA 94520-4969
Phone (510) 268-8120

Other names 1

  • Marian Doud Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
School of Imagination 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1821480229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CONCORD AVE",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204969",
            "telephone_number": "510-268-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 ATLANTIC AVE",
            "address_2": "SUITE 101",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011188",
            "telephone_number": "510-268-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODSIDE",
        "first_name": "MARIAN",
        "middle_name": "ALICE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "11417851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAN",
            "last_name": "DOUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.