Active NPI
Xavier Nathaniel Hunter
- Assistant Behavior Analyst
- Granite Bay, CA
National Provider Identifier
1902326390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- Practice address
- 4196 Douglas Blvd Ste 100
Granite Bay, CA 95746-5904 - Phone
- (916) 489-1376
- NPI assigned
- Jun 27, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | F4498482 | CA | |
| Assistant Behavior Analyst | 106E00000X | CA | Primary |
Addresses
Primary practice location
4196 Douglas Blvd Ste 100
Granite Bay, CA 95746-5904
Mailing address
PO Box 5157
Modesto, CA 95352-5157
Phone (209) 572-2589
Other practice location 1
1027 Park Ln
Piedmont, CA 94610-1124
Phone (415) 748-8052
Other practice location 2
400 29th St Ste 204
Oakland, CA 94609
Phone (510) 679-3545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XDP923A75466 | Other | CA | ANTHEM BLUE CROSS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F4498482 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1902326390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5157",
"city": "MODESTO",
"state": "CA",
"postal_code": "953525157",
"telephone_number": "209-572-2589",
"fax_number": "209-353-3353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4196 DOUGLAS BLVD STE 100",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957465904",
"telephone_number": "916-489-1376"
}
],
"practiceLocations": [
{
"address_1": "1027 Park Ln",
"address_purpose": "LOCATION",
"city": "Piedmont",
"state": "CA",
"postal_code": "946101124",
"country_code": "US",
"telephone_number": "415-748-8052",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 29th St Ste 204",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "94609",
"country_code": "US",
"telephone_number": "510-679-3545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUNTER",
"first_name": "XAVIER",
"middle_name": "NATHANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "F4498482",
"primary": false
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "XDP923A75466",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Granite Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.