Individual provider Active NPI

Analise Marie Benavidez

  • Behavior Analyst
  • Petaluma, CA
National Provider Identifier
1932695640
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1301 Redwood Way Ste 210
Petaluma, CA 94954-1107
Phone
(707) 806-9921
NPI assigned
Jul 5, 2018
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

1301 Redwood Way Ste 210
Petaluma, CA 94954-1107

Mailing address

1301 Redwood Way Ste 210
Petaluma, CA 94954-1134
Phone (707) 219-8972

Other names 1

  • Analise Marie Keehn Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Behavior Services, LLC PastSince Aug 27, 2023 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1932695640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 REDWOOD WAY STE 210",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541134",
            "telephone_number": "707-219-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 REDWOOD WAY STE 210",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541107",
            "telephone_number": "707-806-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDEZ",
        "first_name": "ANALISE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANALISE",
            "last_name": "KEEHN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.