SHADEED HASAN II - NPI 1003130626 - Behavior Analyst in Stockton, CA

Q: What is Shadeed Hasan's NPI number?

The NPI number for Shadeed Hasan is 1003130626. It was assigned to this individual provider in the NPPES registry on March 25, 2010.

Q: What is Shadeed Hasan's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Q: When was this NPI record last updated?

The NPPES record for Shadeed Hasan was last updated on December 28, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Shadeed Hasan Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADEED HASAN II (NPI 1003130626) is an individual behavior analyst provider in Stockton, California, licensed in California (1-16-22697) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS, maintains a secondary practice location in Eureka, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1003130626

Entity TypeIndividualMale

Primary Taxonomy103K00000X

Provider Legal NameSHADEED HASAN II

Location Address1811 GRAND CANAL BLVD STE 2Stockton, CA 95207-8107

Mailing Address500 Fairway Dr Ste 102Deerfield Beach, FL 33441-1817 · (877) 418-2978 · Fax (866) 500-2186

Phone(877) 418-2978

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateMarch 25, 2010

Last NPPES UpdateDecember 28, 20213 updates tracked since enumeration

NPPES CertifiedApril 23, 2021

✔ NPI 1003130626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers

Taxonomy Code103K00000X

License✔ Licensed in CA · 1-16-22697

Definition

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.

Also ListedCounselorTaxonomy 101Y00000X · License 36287 (CA)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License LCSW84937 (CA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1811 GRAND CANAL BLVD STE 2, Stockton, CA 95207

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Secondary Practice Location 1

Location 12413 2nd StEureka, CA 95501-0811 · Phone (707) 269-9590 ext. 201 · Fax (707) 444-8012

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shadeed Hasan Ii is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961851878

PECOS Enrollment IDI20231218000258

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAYNEE YANG

Behavior Technician