Active NPI
Sandra J Smith, LEP, BCBA
- Behavior Analyst
- Moorpark, CA
National Provider Identifier
1841575404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LEP2570 BCBA1118037
- Practice address
- 4808 Far Country CT
Moorpark, CA 93021-3521 - Phone
- (805) 428-0948
- NPI assigned
- Oct 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | LEP2570 BCBA1118037 | CA | Primary |
| Psychologist | 103T00000X | LEP2570 | CA |
Addresses
Primary practice location
4808 Far Country CT
Moorpark, CA 93021-3521
Mailing address
4808 Far Country CT
Moorpark, CA 93021-3521
Phone (805) 428-0948
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
| License | State | Type | Specialty |
|---|---|---|---|
| LEP2570 BCBA1118037 | CA | MD | Behavioral Analyst |
| LEP2570 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1841575404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4808 FAR COUNTRY CT",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930213521",
"telephone_number": "805-428-0948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4808 FAR COUNTRY CT",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930213521",
"telephone_number": "805-428-0948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SANDRA",
"middle_name": "J",
"credential": "LEP, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-14",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "LEP2570 BCBA1118037",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "LEP2570",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorpark, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.