Active NPI
Alexandra Zachary, M.A, BCBA
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1861084501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12045405
- Practice address
- 2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339 - Phone
- (626) 755-8264
- NPI assigned
- Feb 4, 2021
- Last updated
- Dec 9, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 12045405 | CA | Primary |
Addresses
Primary practice location
2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339
Mailing address
2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339
Phone (626) 755-8264
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12045405 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Sprout MC 1 LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1861084501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2338 W ROYAL PALM RD STE J",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850219339",
"telephone_number": "626-755-8264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2338 W ROYAL PALM RD STE J",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850219339",
"telephone_number": "626-755-8264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZACHARY",
"first_name": "ALEXANDRA",
"credential": "M.A, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-04",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "12045405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.