Active NPI
Susana Macias, M.A. BCBA
- Behavior Analyst
- Stockton, CA
National Provider Identifier
1932600947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-55325
- Practice address
- 2303 Whistler Way
Stockton, CA 95209-4157 - Phone
- (209) 953-8106
- NPI assigned
- Feb 24, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-55325 | CA | Primary |
| Behavior Technician | 106S00000X | RBT-17-45747 | CA |
Addresses
Primary practice location
2303 Whistler Way
Stockton, CA 95209-4157
Mailing address
2740 Rosewood Ave
Ceres, CA 95307-2038
Phone (209) 872-4527
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-45747 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1932600947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 ROSEWOOD AVE",
"city": "CERES",
"state": "CA",
"postal_code": "953072038",
"telephone_number": "209-872-4527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2303 WHISTLER WAY",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952094157",
"telephone_number": "209-953-8106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACIAS",
"first_name": "SUSANA",
"name_prefix": "Mrs.",
"credential": "M.A. BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-24",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-21-55325",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-17-45747",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.