Active NPI
Wang Pan
- Behavior Analyst
- South Pasadena, CA
National Provider Identifier
1972199073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-60108
- Practice address
- 99 Pasadena Ave Ste 10C
South Pasadena, CA 91030-6142 - Phone
- (323) 341-5580
- NPI assigned
- Dec 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-60108 | CA | Primary |
Addresses
Primary practice location
99 Pasadena Ave Ste 10C
South Pasadena, CA 91030-6142
Mailing address
99 Pasadena Ave Ste 10C
South Pasadena, CA 91030-6142
Phone (626) 219-9258
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1972199073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 PASADENA AVE STE 10C",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910306142",
"telephone_number": "626-219-9258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 PASADENA AVE STE 10C",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910306142",
"telephone_number": "323-341-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "WANG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-14",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-22-60108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.