PACIFIC AUTISM LEARNING SERVICES, INC (NPI# 1336435734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336435734 |
| Entity Type | Organization |
| Organization Name | PACIFIC AUTISM LEARNING SERVICES, INC |
| Practice Address |
1710 S Amphlett Blvd Ste 314 San Mateo CA 94402-2703 |
| Mailing Address |
1328 Blue Oaks Blvd Suite 180 Roseville CA 95678-7031 |
| Practice Telephone | 6502420179 |
| Practice Fax Number | 6502428202 |
| Mailing Telephone | 9166760488 |
| Mailing Fax Number | 9167714370 |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |
| Authorized Official Name | DR. GREGORY BUCH (OWNER/DIRECTOR) |
| Authorized Official Telephone | 9166760488 |
| Authorized Official Credential | PH.D., BCBA-D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
1710 S AMPHLETT BLVD STE 314 |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-2703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669525911 | Farzana Amin | Psychiatry & Neurology | 1710 S Amphlett Blvd, Suite 301, San Mateo, CA 94402-2703 | 2007-01-19 |
| 1497380901 | Charles Phinehas Schwartz IIi | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2020-03-04 |
| 1144860586 | Camille Evelyn Kellstedt | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2020-01-14 |
| 1417599614 | Pragna Tantravahi | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402 | 2019-10-09 |
| 1942859020 | Peter M Kitsamba | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-09-10 |
| 1053960138 | Ben Chettipally | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-09-10 |
| 1750938775 | Sabrina Kelly Gonzales | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-08-23 |
| 1578123477 | Matthew Wong | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-06-13 |
| 1619536679 | Amanda Rodriguez | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-06-12 |
| 1083271829 | Elydia Gonzalez | Behavioral Analyst | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-05-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
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| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992252829 | Caminar Inc. | Community/Behavioral Health | 1660 S Amphlett Blvd Ste 11, San Mateo, CA 94402-2520 | 2016-09-08 |
| 1649403486 | Healthright 360 | Community/Behavioral Health | 2015 Pioneer Ct, San Mateo, CA 94403-1781 | 2009-08-27 |
| 1245428473 | Training and Health Education Center for Youth | Community/Behavioral Health | 900 Alameda De Las Pulgas, # 224, San Mateo, CA 94402-3357 | 2007-10-12 |
| 1427242163 | County of San Mateo | Community/Behavioral Health | 2000 Alameda De Las Pulgas Ste 280, San Mateo, CA 94403-1289 | 2007-09-05 |
| 1093920647 | Edgewood Center for Children and Families | Community/Behavioral Health | 1510 Fashion Island Blvd Ste 310, San Mateo, CA 94404-1587 | 2007-05-14 |
| 1225240211 | Dr. June Martin, Marriage and Family Therapist, Inc. | Community/Behavioral Health | 215 North San Mateo Drive, Suite #2, San Mateo, CA 94401 | 2007-05-04 |
| 1184768665 | Excell Readiness Center | Community/Behavioral Health | 22 Tower Rd, San Mateo, CA 94402-4035 | 2007-02-16 |
| 1316084072 | Ymca of San Francisco | Community/Behavioral Health | 1650 S. Amphlett Blvd., Suite 113, San Mateo, CA 94402 | 2007-01-31 |
| 1306983887 | Starvista Girls Program | Community/Behavioral Health | 400 Paul Scannell Drive, San Mateo, CA 94402 | 2007-01-31 |
| 1346395738 | Caminar | Community/Behavioral Health | 2600 S. El Camino Real, 1st Floor, San Mateo, CA 94403 | 2007-01-24 |
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| 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.