MATTHEW FIDUK (NPI# 1871097709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871097709 |
| Entity Type | Individual |
| Full Name | MATTHEW FIDUK |
| Practice Address |
1111 Baker St Ste A Costa Mesa CA 92626-4138 |
| Mailing Address |
1055 E Colorado Blvd Ste 560 Pasadena CA 91106-2380 |
| Practice Telephone | 8182416780 |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2019-09-20 |
| 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 |
| Street Address |
1111 BAKER ST STE A |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639442502 | Gina Chang | Psychologist | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2012-02-22 |
| 1013543404 | Valeria Gonzalez Del Valle | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2020-03-17 |
| 1003447947 | Gerardo Leon | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2020-01-29 |
| 1376174524 | Bryaunna Chanel Zuniga | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2020-01-27 |
| 1689214066 | Alma D Gamboa | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2020-01-13 |
| 1528608254 | Courtney Nelson | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2020-01-10 |
| 1164060570 | Cathy Kitinoja | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2019-12-16 |
| 1740827757 | Rubi Flores | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2019-12-09 |
| 1104463116 | Jennifer V Lozano | Behavior Technician | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2019-12-09 |
| 1366088916 | Ariani Vandini | Behavioral Analyst | 1111 Baker St Ste A, Costa Mesa, CA 92626-4138 | 2019-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| 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 |
|---|---|---|---|---|
| 1528602448 | Maria Isabel Acosta Gutierrez | Behavioral Analyst | 3186 Airway Ave # Atea, Costa Mesa, CA 92626-4650 | 2019-11-04 |
| 1295378305 | Quynh Le | Behavioral Analyst | 1111 Baker St # 8, Costa Mesa, CA 92626-4138 | 2019-10-21 |
| 1558922427 | Roya Haddadzadeh | Behavioral Analyst | 3303 Harbor Blvd. Suite B8, Costa Mesa, CA 92626-5212 | 2019-06-21 |
| 1912466590 | Kiana Pinawin | Behavioral Analyst | 1503 S Coast Dr Ste 212, Costa Mesa, CA 92626-1556 | 2019-03-13 |
| 1427516764 | Oscar Zuniga | Behavioral Analyst | 3186 Airway Ave. Bldg.a, Costa Mesa, CA 92626 | 2019-03-05 |
| 1841755378 | Rachel E Rangel | Behavioral Analyst | 151 Kalmus Dr Ste L1, Costa Mesa, CA 92626-5978 | 2019-02-08 |
| 1770056111 | Casey Elyssa Mann | Behavioral Analyst | 3554 Business Park Dr, Costa Mesa, CA 92626-1423 | 2019-01-08 |
| 1437626470 | Chiamaka Oranuba | Behavioral Analyst | 3816 Airway Ave, Suite A, Costa Mesa, CA 92626 | 2018-10-29 |
| 1356822787 | United Behavior Consultants | Behavioral Analyst | 826 Joann St, Costa Mesa, CA 92627-3321 | 2018-08-23 |
| 1366931537 | Kristen Schreiber | Behavioral Analyst | 3186 Airway Ave, Costa Mesa, CA 92626-4650 | 2018-05-03 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.