SPENCER ANNABELLE SULLIVAN (NPI# 1144863085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144863085 |
| Entity Type | Individual |
| Full Name | SPENCER ANNABELLE SULLIVAN |
| Practice Address |
877 Ygnacio Valley Rd Ste 100 Walnut Creek CA 94596-3897 |
| Practice Telephone | 9254823329 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073735114 | Spencer K Sullivan | Pediatrics | 7730 Old Canton Rd Bldg B, Madison, MS 39110 | 2007-05-02 |
| Street Address |
877 YGNACIO VALLEY RD STE 100 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-3897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124450473 | Ameena Sweeting | Behavioral Analyst | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2013-08-08 |
| 1760081970 | Haley Raquel Alcayde | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-10-19 |
| 1174121669 | Sofia Marina Ruiz-lopez | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-10-15 |
| 1669088019 | Raquel Perez | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-09-21 |
| 1013523901 | Evonne Pham Nguyen | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-09-17 |
| 1356957112 | Anna Chan | Behavioral Analyst | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-09-17 |
| 1407461437 | Lacey Jill Reese | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-09-15 |
| 1013528389 | Ashley R Nelson | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-08-11 |
| 1952912453 | Frances Anne Yabut Mariano | Behavioral Analyst | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-08-10 |
| 1891305421 | Kai Chun Yung | Behavior Technician | 877 Ygnacio Valley Rd Ste 100, Walnut Creek, CA 94596-3897 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821240 | Alexandra Morgan Hagerty | Behavior Technician | 2681 Baldwin Ln, Walnut Creek, CA 94597-2613 | 2020-11-04 |
| 1871191288 | Olivia M Tugwell | Behavior Technician | 628 Tarrytown Ct, Walnut Creek, CA 94598-4022 | 2020-10-16 |
| 1952928632 | Leslie Priscilla Padilla | Behavior Technician | 3075 Citrus Cir # 249, Walnut Creek, CA 94598-2666 | 2020-06-29 |
| 1578100491 | Marlina Mora | Behavior Technician | 710 S Broadway Ste 100, Walnut Creek, CA 94596-5228 | 2019-12-10 |
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1114491081 | Carolyn G Wolf-flores | Behavior Technician | 313 Lennon Ln, Walnut Creek, CA 94598-2498 | 2019-01-14 |
| 1780154898 | Daniel Fenton | Behavior Technician | 1620 N Main St Ste 1, Walnut Creek, CA 94596-4653 | 2018-11-30 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1417423542 | Christina Howie Faye Moscato | Behavior Technician | 877 Ygnacio Valley Rd Ste 101, Walnut Creek, CA 94596-3897 | 2018-10-16 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
Please comment or provide details below to improve the information on SPENCER ANNABELLE SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.