Individual provider Active NPI

Mila Amerine-Dickens, BCBA

  • Behavior Analyst
  • Modesto, CA
National Provider Identifier
1992043665
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-00-0243 Issued in CA
Practice address
1317 Oakdale Rd Ste 800
Modesto, CA 95355-3366
Phone
(209) 521-4791
Fax
(209) 521-4794
NPI assigned
Jan 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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 1-00-0243 CA Primary

Addresses

Primary practice location

1317 Oakdale Rd Ste 800
Modesto, CA 95355-3366

Mailing address

1317 Oakdale Rd Ste 800
Modesto, CA 95355-3366
Phone (209) 521-4791

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": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1992043665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 OAKDALE RD STE 800",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553366",
            "telephone_number": "209-521-4791",
            "fax_number": "209-521-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 OAKDALE RD STE 800",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553366",
            "telephone_number": "209-521-4791",
            "fax_number": "209-521-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMERINE-DICKENS",
        "first_name": "MILA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-00-0243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.