Healthcare Provider Details

I. General information

NPI: 1700700549
Provider Name (Legal Business Name): JAMES XIA MA MOUA MA, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 CIRO AVE STE 240
SAN JOSE CA
95128-1671
US

IV. Provider business mailing address

765 MONTAGUE EXPY APT 417
MILPITAS CA
95035-8867
US

V. Phone/Fax

Practice location:
  • Phone: 650-777-8611
  • Fax:
Mailing address:
  • Phone: 559-696-8615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2832426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: