Individual provider Active NPI

Priscilla Olmos, B.S.

  • Behavior Analyst
  • Victorville, CA
National Provider Identifier
1073991600
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
B7949174 Issued in CA
Practice address
13901 Amargosa Rd
Suite 2
Victorville, CA 92392-2409
Phone
(760) 512-1925
NPI assigned
May 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X B7949174 CA Primary

Addresses

Primary practice location

13901 Amargosa Rd
Suite 2
Victorville, CA 92392-2409

Mailing address

2456 Front St
San Diego, CA 92101-1416
Phone (619) 817-1123

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
B7949174CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1073991600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 FRONT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011416",
            "telephone_number": "619-817-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13901 AMARGOSA RD",
            "address_2": "SUITE 2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922409",
            "telephone_number": "760-512-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMOS",
        "first_name": "PRISCILLA",
        "name_prefix": "Miss",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "B7949174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.