Jessica Rydberg, M.ED, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

4530 E Muirwood Dr
Suite 103
Phoenix, AZ 85048-7639

Phone

(480) 610-6981

NPI assigned

Jul 27, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jessica Molloy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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  • NPI 1114285855

  Behavior Analyst

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1013392497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 W WINCHCOMB DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850235930",
            "telephone_number": "623-236-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "SUITE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487639",
            "telephone_number": "480-610-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDBERG",
        "first_name": "JESSICA",
        "credential": "M.ED, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MOLLOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy John Ryan, DO
• Vance Edward Ryan, O.D.
• Cindy Ryanto
• Jaclyn Rybin, RDN
• Daniel John Rydberg
• David Joseph Ryder, M.D.
• Jessica M Ryder, PT
• Katherine Ryder
• Kristin Lee Ryder, MS
• Lee Ryder, DPT

• Behavior Analyst in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.