BLAKE HENDERSON (NPI# 1689178584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689178584 |
| Entity Type | Individual |
| Full Name | BLAKE HENDERSON |
| Credential | BCBA, M. ED. |
| Practice Address |
3230 E Imperial Hwy Ste 203 Brea CA 92821-1706 |
| Practice Telephone | 6574449002 |
| Mailing Telephone | 6574449002 |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1-17-29346 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295342848 | Blake Russell Henderson | Massage Therapist | 515 W 75th St, Kansas City, MO 64114-1512 | 2020-09-28 |
| 1992064893 | Blake Tarleton Henderson | Student in an Organized Health Care Education/Training Program | 2425 Geary Blvd # M160, San Francisco, CA 94115-3358 | 2012-05-11 |
| Street Address |
3230 E IMPERIAL HWY STE 203 |
| City | BREA |
| State | CA |
| Zip Code | 92821-1706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902272586 | Vicki Sasahara | Behavioral Analyst | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2015-08-18 |
| 1033769278 | Arlene Victoria Ledesma | Behavioral Analyst | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-09-19 |
| 1578113114 | Stephanie Ramirez | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-09-16 |
| 1871153502 | Sally Anne Ungheanu | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-06-14 |
| 1295395192 | Celeste Marlene Galindo | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-06-13 |
| 1467012377 | Joshua C Matayka | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-06-13 |
| 1477013092 | Rosario Rivera | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-20 |
| 1982164653 | Danielle Boswell | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-20 |
| 1114487816 | Camilla Dungca | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-20 |
| 1144780750 | Melissa Francis | Behavior Technician | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844921 | Christina Marie Iezza | Physical Medicine & Rehabilitation | 500 W. Central Ave, Suite B, Brea, CA 92821 | 2020-02-28 |
| 1962052068 | Joanne Chung | Behavioral Analyst | 3050 Saturn Street, #102, Brea, CA 92821 | 2019-09-19 |
| 1508336736 | Sonia Montez | Physical Therapy Assistant | Jump N Schout, 500 W Central Ave, Brea, CA 92821 | 2018-11-30 |
| 1215411921 | Eye View Optometry, Inc | Optometrist | 605 E. Imperial Hwy, Suite C, Brea, CA 92821 | 2018-09-18 |
| 1700395480 | Sheetal Patel | Registered Nurse | 955 W. Imperial Hwy., Suite 220, Brea, CA 92821 | 2017-09-25 |
| 1952827826 | Grace Cho | Occupational Therapist | 875 N Brea Blvd # 600, Brea, CA 92821 | 2017-08-22 |
| 1063959781 | Veronica Meza | Lactation Consultant, Non-RN | 551 Discovery Lane, #115, Brea, CA 92821 | 2017-01-20 |
| 1780045815 | Audrey Alva | Specialist/Technologist | 460 W. Lambert Road, Brea, CA 92821 | 2016-03-17 |
| 1558734921 | Eun Kim Chiropractic Inc | Chiropractor | 411 Atlas Street, Suite A, Brea, CA 92821 | 2015-11-07 |
| 1053784512 | Caremore Health Plan | Nurse Practitioner | 420 W. Central Avenue #a, Brea, CA 92821 | 2015-11-05 |
| Find all providers in zip 92821 | ||||
| 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 |
|---|---|---|---|---|
| 1962052068 | Joanne Chung | Behavioral Analyst | 3050 Saturn Street, #102, Brea, CA 92821 | 2019-09-19 |
| 1760839724 | Robert Foster | Behavioral Analyst | 3050 Saturn St Ste 102, Brea, CA 92821-6281 | 2016-05-19 |
| 1902272586 | Vicki Sasahara | Behavioral Analyst | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2015-08-18 |
| 1649896176 | Ixzel Gonzalez Ceballos | Behavioral Analyst | 3050 Saturn St Ste 102, Brea, CA 92821-6281 | 2020-06-20 |
| 1497375026 | Neerav Mangipudi | Behavioral Analyst | 3050 Saturn St, Brea, CA 92821-6221 | 2020-04-23 |
| 1093343444 | Taylor Faust | Behavioral Analyst | 3050 Saturn St Ste 102, Brea, CA 92821-6281 | 2020-03-31 |
| 1427684778 | Eileen Yoo | Behavioral Analyst | 3050 Saturn St Ste 102, Brea, CA 92821-6281 | 2020-03-18 |
| 1033769278 | Arlene Victoria Ledesma | Behavioral Analyst | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-09-19 |
| 1619436102 | Robert Dickinson | Behavioral Analyst | 3050 Saturn St Ste 102, Brea, CA 92821-6281 | 2019-03-14 |
| 1245799808 | Tiffani Sue Earnest | Behavioral Analyst | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2019-03-13 |
| Find all providers in BREA | ||||
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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.