Madeline Cassandra Douglas

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

26347 Issued in CA

Practice address

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Phone

(213) 253-2677

Fax

(213) 253-5046

NPI assigned

Nov 25, 2011

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment NPD
• Madeline C Douglas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Redlands, CA
  • NPI 1992551691
  NPD Authorized official

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

{
    "created_epoch": "1322179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322179200000",
    "number": "1861769432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "213-253-2677",
            "fax_number": "213-253-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "213-253-2677",
            "fax_number": "213-253-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MADELINE",
        "middle_name": "CASSANDRA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-25",
        "last_updated": "2011-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "26347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Elise Douglas, MD
• Christopher M Ryan Douglas, BA
• Elizabeth Weston Douglas
• Ian Douglas
• Kristine M Douglas, LCSW, MPH
• Madison Douglas, MD
• Michael Adam Douglas, PHD
• Sonsearay Douglas
• Stephanie Denese Douglas
• Tarese Douglas, MT

• Behavior Analyst in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.