Active NPI
Jason Matty, M.ED., PPS, BCBA
- Behavior Analyst
- San Jose, CA
National Provider Identifier
1891054276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-13-13334
- Practice address
- 522 Clifton Ave
San Jose, CA 95128 - Phone
- (408) 490-0192
- NPI assigned
- May 6, 2012
- 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 | 1-13-13334 | CA | Primary |
Addresses
Primary practice location
522 Clifton Ave
San Jose, CA 95128
Mailing address
522 Clifton Ave
San Jose, CA 95128-2315
Phone (408) 490-0192
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 Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1891054276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 CLIFTON AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282315",
"telephone_number": "408-490-0192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 CLIFTON AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95128",
"telephone_number": "408-490-0192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTY",
"first_name": "JASON",
"credential": "M.ED., PPS, BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-06",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-13-13334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.