Atiyyah Jasmin Thompson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

46-0508169 Issued in CA

Practice address

805 Main St Ste L
Susanville, CA 96130-4457

Phone

(424) 603-8377

NPI assigned

Jan 2, 2019

Reactivated

Oct 5, 2021

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Atiyyah Jasmin Joseph Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1972076974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 OAKHEATH DR",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907101223",
            "telephone_number": "424-603-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MAIN ST STE L",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961304457",
            "telephone_number": "424-603-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ATIYYAH",
        "middle_name": "JASMIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "deactivation_date": "2021-09-10",
        "reactivation_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "46-0508169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATIYYAH",
            "last_name": "JOSEPH",
            "middle_name": "JASMIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steve Tank, RN
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• Kirk Leon Thompson, CRNA
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• Thelma Tidwell
• Anna Townsend
• Eric P Trevizu, PSYD

• Behavior Analyst in Susanville, CA
• Providers in Susanville, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.