MEDICARE: COMPASSIONATE BEHAVIOR SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1659995918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE BEHAVIOR SERVICES

Provider Business Mailing Address
First Line	:	4848 E ROOSEVELT ST APT 3006
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-7338
Country	:	US
Telephone Number	:	602-688-4080
Fax Number	:	602-892-1829

Provider Business Practice Location Address
First Line	:	4848 E ROOSEVELT ST APT 3006
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-7338
Country	:	US
Telephone Number	:	602-688-4080
Fax Number	:	602-892-1829

Authorized Official
Title or Position	:	CEO
Name	:	MR. FERNANDO W MARTINEZ JR.
Credential	:	BCBA
Telephone Number	:	602-688-4080

Provider Enumeration Date	:	06/02/2020
Last Update Date	:	01/21/2026

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