Active NPI
Natalie Formento, MED, BCBA
- Behavior Analyst
- Chula Vista, CA
National Provider Identifier
1972386696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1357
- Practice address
- 310 3Rd Ave Ste B8
Chula Vista, CA 91910-3990 - Phone
- (855) 223-7123
- Fax
- (619) 374-7134
- NPI assigned
- Aug 16, 2023
- Sex
- Female
- 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 | 1357 | TN | Primary |
Addresses
Primary practice location
310 3Rd Ave Ste B8
Chula Vista, CA 91910-3990
Mailing address
PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q088601 | Medicaid | TN |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1357 | TN | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopebridge LLC | Behavior Analyst | Past | 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 and National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Brentwood, TN
- NPI 1881352177
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1972386696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33568",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921633568",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 3RD AVE STE B8",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919103990",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMENTO",
"first_name": "NATALIE",
"credential": "MED, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-16",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "1357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q088601",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.