Individual provider Active NPI

Kyler Smith

  • Behavior Analyst
  • San Bernardino, CA
National Provider Identifier
1073300869
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
805 N D St
San Bernardino, CA 92401-1017
Phone
(909) 893-2782
Fax
(909) 893-2782
NPI assigned
Apr 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CA Primary
Community Health WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 172V00000X

Addresses

Primary practice location

805 N D St
San Bernardino, CA 92401-1017

Mailing address

805 N D St
San Bernardino, CA 92401-1017
Phone (909) 893-2782

Other practice location 1

4141 S Nogales St Unit A104
West Covina, CA 91792-3057
Phone (310) 490-8374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1073300869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011017",
            "telephone_number": "909-893-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011017",
            "telephone_number": "909-893-2782",
            "fax_number": "909-893-2782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4141 S Nogales St Unit A104",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917923057",
            "country_code": "US",
            "telephone_number": "310-490-8374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-23",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.