Individual provider Active NPI

Destane Anastasia Lindsay

  • Behavior Analyst
  • Hayward, CA
National Provider Identifier
1831763739
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
Y2763364 Issued in CA
Practice address
25800 Industrial Blvd Apt 1117
Hayward, CA 94545-2982
Phone
(408) 856-5827
NPI assigned
May 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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 Y2763364 CA Primary

Addresses

Primary practice location

25800 Industrial Blvd Apt 1117
Hayward, CA 94545-2982

Mailing address

25800 Industrial Blvd Apt 1117
Hayward, CA 94545-2982
Phone (408) 856-5827

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

State licenses

LicenseStateTypeSpecialty
Y2763364CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1831763739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25800 INDUSTRIAL BLVD APT 1117",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452982",
            "telephone_number": "408-856-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25800 INDUSTRIAL BLVD APT 1117",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452982",
            "telephone_number": "408-856-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "DESTANE",
        "middle_name": "ANASTASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "Y2763364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.

Verify at the official NPI Registry.