Theresa Bartholomew

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-23985 Issued in CA

Practice address

12465 Lewis St Ste 102
Garden Grove, CA 92840-4658

Phone

(949) 833-2237

NPI assigned

Dec 29, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1831634831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE",
            "address_2": "SUITE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926069928",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST STE 102",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "949-833-2237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16782 Von Karman Ave",
            "address_2": "Suite 11",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926069928",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-16-23985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rachel Bastone

• Behavior Analyst in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.