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Andy Park , BCBA

Behavior Analyst β€’ San Leandro, CA

Active NPI 1558868588 Individual Practitioner Male Practitioner
Practice location in NPPES

13847 E 14th St Ste 217
San Leandro, CA 945782626

Call 8888050759 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

13847 E 14th St Ste 217

San Leandro, CA 945782626

Telephone 8888050759
Organization at the Same NPPES Address or Phone
Psychology Diagnostic Services, Pc Facility NPI 1881205946

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in San Leandro and California

53 active clinicians are listed under Behavior Analyst with a practice address in San Leandro, CA (20,363 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in San Leandro

0% of these 53 clinicians have the CMS telehealth indicator.

0% of these 53 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-12-21
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES CA 1-21-56691

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location December 21, 2021

Registered at 13847 E 14TH ST STE 217, SAN LEANDRO, CA 945782626 (Tel: 8888050759)

πŸ“
Updated Business Mailing Address December 21, 2021

Registered at 1333 S MAYFLOWER AVE STE 220, MONROVIA, CA 910164066 (Tel: 8888050759)

πŸ‘€
Provider Name / Credentials Updated December 21, 2021

Recorded as ANDY PARK, BCBA

βœ…
NPI Profile Active April 06, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 06, 2018

Registered at 1485 SARATOGA AVE STE 200, SAN JOSE, CA 951294965 (Tel: 8779910009)

πŸ“
Business Mailing Address (Initial Record) April 06, 2018

Registered at 1485 SARATOGA AVE STE 200, SAN JOSE, CA 951294965 (Tel: 8779910009)

πŸ‘€
Provider Name / Credentials (Initial Record) April 06, 2018

Recorded as ANDY PARK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2018

Counselor

🟒
Initial NPI Registration & Enumeration April 06, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1558868588
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 06, 2018
Last Update: December 21, 2021
Sole Proprietor: Yes

Mailing Address

1333 S Mayflower Ave Ste 220

Monrovia, CA 910164066

Phone: 8888050759

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.