JORGE LUIS GAMBOA (NPI# 1790294148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790294148 |
| Entity Type | Individual |
| Full Name | JORGE LUIS GAMBOA |
| Practice Address |
255 W Martin Luther King Blvd Unit 1217 Charlotte NC 28202-1980 |
| Mailing Address |
1401 E 7th St Charlotte NC 28204-6300 |
| Practice Telephone | 9192607358 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2019-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902322696 | Jorge Gamboa | Rehabilitation Practitioner | 1159 E Alvarado St, Pomona, CA 91767-5139 | 2017-08-15 |
| 1114403334 | Jorge Gamboa | Behavior Technician | 2130 E 4th St Ste 200, Santa Ana, CA 92705-3818 | 2018-07-11 |
| Street Address |
255 W MARTIN LUTHER KING BLVD UNIT 1217 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28202-1980 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609418425 | Monarch | Community/Behavioral Health | 215 North Pine Street Unit 705, Charlotte, NC 28202 | 2019-10-14 |
| 1396211892 | Brooke Graham | Behavior Technician | 107 New Edition Court Carey, Raleigh, NC 28202 | 2018-10-23 |
| 1740704352 | Targetcare, Inc. | Health Educator | 831 E. Morehead Street, Suite 900, Charlotte, NC 28202 | 2017-07-26 |
| 1659828291 | Reserve Health, PC | Family Medicine | 135 W 10th St, Charlotte, NC 28202 | 2016-09-01 |
| 1275905887 | Tameka Wade Brewington | Counselor | 615 E 6th St Ste 112, Charlotte, NC 28202 | 2015-10-22 |
| 1962815159 | Teisha Miller | Social Worker | 700 N. Tryon Street, Charlotte, NC 28202 | 2014-06-05 |
| 1699193672 | Elizabeth Ann Peterson-vita | Psychologist | 700 East Stonewall Street, Suite 714, Charlotte, NC 28202 | 2014-04-07 |
| 1942631437 | Avery Sales | Durable Medical Equipment & Medical Supplies | 103 W Morehead St, Charlotte, NC 28202 | 2013-12-09 |
| 1801236484 | Annette Goodman | Counselor | 415 E. Trade Street, Charlotte, NC 28202 | 2013-06-27 |
| 1174960181 | Jennifer D'silva | Dentist | 210 E Trade St # 484, Charlotte, NC 28202 | 2013-05-30 |
| Find all providers in zip 28202 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| 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. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513496 | Alicia Renee Costner | Behavioral Analyst | 13001 Seascape Ln, Charlotte, NC 28278-7113 | 2019-11-27 |
| 1659932713 | Delia Conroy | Behavioral Analyst | 1420 Abbey Pl Apt 217, Charlotte, NC 28209-3071 | 2019-06-27 |
| 1508332982 | Behavioral Health Management | Behavioral Analyst | 1016 Jordans Pond Ln, Charlotte, NC 28214-7148 | 2018-10-23 |
| 1760967855 | Pwandra Natalia Robinson | Behavioral Analyst | 707 Yorkdale Dr, Charlotte, NC 28217-3494 | 2018-09-25 |
| 1184106502 | Janelle Gillis | Behavioral Analyst | 13354 Calloway Glen Dr, Charlotte, NC 28273 | 2018-09-01 |
| 1396226106 | Brandi Finger | Behavioral Analyst | 10471 Alexander Martin Ave, Charlotte, NC 28277-8192 | 2018-08-29 |
| 1356822696 | Staci Lynne Kolko | Behavioral Analyst | 17206 Lancaster Hwy Ste 501, Charlotte, NC 28277-2004 | 2018-08-24 |
| 1639650005 | Bonnie Y Anderson | Behavioral Analyst | 5200 77 Center Dr Ste 130, Charlotte, NC 28217-0742 | 2018-08-23 |
| 1740775030 | Acceptwc | Behavioral Analyst | 2600 W Trade St, Charlotte, NC 28208-3245 | 2018-06-28 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on JORGE LUIS GAMBOA.
| 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.