Active NPI
Samara Shore
- Behavior Analyst
- San Bruno, CA
National Provider Identifier
1881268530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1815
- Practice address
- 1001 Sneath LN Ste 200
San Bruno, CA 94066-2349 - Phone
- (916) 382-4447
- NPI assigned
- May 18, 2021
- 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 | 1815 | TN | Primary |
Addresses
Primary practice location
1001 Sneath LN Ste 200
San Bruno, CA 94066-2349
Mailing address
2129 E 6TH St
Long Beach, CA 90814-1010
Phone (714) 916-2559
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743638400000",
"number": "1881268530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2129 E 6TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908141010",
"telephone_number": "714-916-2559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SNEATH LN STE 200",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940662349",
"telephone_number": "916-382-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "SAMARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-18",
"last_updated": "2025-04-03",
"certification_date": "2025-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "1815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.