Kandra Rae Wiseman, MA BCBA BHP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA-0258 Issued in AZ

Practice address

1830 S Alma School Rd Ste 130
Mesa, AZ 85210-3088

Phone

(602) 510-5401

NPI assigned

Dec 14, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arizona Autism United, Inc.

  • Behavior Analyst
  • Mesa, AZ
  • NPI 1750913364
  NPD (past)
• Arizona Autism United, Inc.

  • Behavior Analyst
  • Phoenix, AZ
  • NPI 1760621379
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1932643624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 N 52ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850083402",
            "telephone_number": "602-510-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 S ALMA SCHOOL RD STE 130",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103088",
            "telephone_number": "602-510-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "KANDRA",
        "middle_name": "RAE",
        "credential": "MA BCBA BHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BA-0258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brycen Rhett Wintch, FNP-C
• Robert Alan Winter, DO
• Shannon Winters, RN
• Duane Lee Wirth, DDS
• Holly Wirtz, PT
• Liane Wisman, NUTRITION COACH
• Michael Wisness, PHARM.D.
• Katie Witchley
• Ralph C Witmer III, PHARM.D.
• Crystal Marie Witt

• Behavior Analyst in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.