Perry Duane Bogdan

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1025 Atlantic Ave Ste 101
Alameda, CA 94501-1188

Phone

(510) 268-8120

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1992450480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5271 HENDRICKSEN DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926492416",
            "telephone_number": "562-756-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 ATLANTIC AVE STE 101",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011188",
            "telephone_number": "510-268-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDAN",
        "first_name": "PERRY",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "5271 Hendricksen Dr",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926492416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julian Blecken
• Ernest Bloom, MD
• Richard Kenneth Bloom, PHD
• Blue Arrow Behavioral Services
• Laurie F Bochner, M.S. CCC-SLP
• Doris Maria Bognar
• Marketa Novosadova Boller
• Claire Bonde, OTR/L
• Dayisha Ashley Boney
• Ernest Lincoln Bonner Jr., MD

• Behavior Technician in Alameda, CA
• Providers in Alameda, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.