Active NPI
John James Klock Jr., M.A., BCBA
- Behavior Analyst
- Riverside, CA
National Provider Identifier
1871080648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-18-29354
- Practice address
- 4696 Maxwell CT
Riverside, CA 92501-3902 - Phone
- (714) 679-3861
- NPI assigned
- Apr 17, 2018
- Sex
- Male
- 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 | 1-18-29354 | CA | Primary |
Addresses
Primary practice location
4696 Maxwell CT
Riverside, CA 92501-3902
Mailing address
4696 Maxwell CT
Riverside, CA 92501-3902
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523923200000",
"number": "1871080648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4696 MAXWELL CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925013902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4696 MAXWELL CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925013902",
"telephone_number": "714-679-3861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOCK",
"first_name": "JOHN",
"middle_name": "JAMES",
"name_suffix": "Jr.",
"credential": "M.A., BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-17",
"last_updated": "2018-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-18-29354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.