Individual provider Active NPI

Christina Panteloglow, BCBA, LBA

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1962905414
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-57666 Issued in CA
Practice address
2 N Central Ave Ste 1800
Phoenix, AZ 85004-2139
Phone
(602) 807-5678
NPI assigned
Mar 12, 2018
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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 1-22-57666 CA Primary

Addresses

Primary practice location

2 N Central Ave Ste 1800
Phoenix, AZ 85004-2139

Mailing address

3620 Spenceville Rd
Wheatland, CA 95692-9754
Phone (916) 581-3652

Other practice location 1

3620 Spenceville Rd
Wheatland, CA 95692-9754
Phone (916) 581-3652

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
Rad ABA LLC CurrentSince Aug 14, 2022 Accepting new patients
Rad ABA LLC Behavior Analyst Current Accepting new patients

Organizations & group practices 2

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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1962905414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 SPENCEVILLE RD",
            "city": "WHEATLAND",
            "state": "CA",
            "postal_code": "956929754",
            "telephone_number": "916-581-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N CENTRAL AVE STE 1800",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042139",
            "telephone_number": "602-807-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3620 Spenceville Rd",
            "address_purpose": "LOCATION",
            "city": "Wheatland",
            "state": "CA",
            "postal_code": "956929754",
            "country_code": "US",
            "telephone_number": "916-581-3652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTELOGLOW",
        "first_name": "CHRISTINA",
        "name_prefix": "Ms.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-22-57666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.