NPIMap

Individual provider Active NPI

Katelyn Anne Zissimos, BCBA

  • Behavior Analyst
  • Murrieta, CA
National Provider Identifier
1083199723
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-66888 Issued in CA
Practice address
41760 Ivy St Ste 101
Murrieta, CA 92562-9416
Phone
(951) 595-4673
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X WA
Behavior Analyst 103K00000X 1-23-66888 CA Primary

Addresses

Primary practice location

41760 Ivy St Ste 101
Murrieta, CA 92562-9416

Mailing address

41760 Ivy St Ste 101
Murrieta, CA 92562-9416
Phone (951) 595-4673

Other practice location 1

Leaps and Beyond Inc. 231 SE Barrington Dr. Ste 203
Oak Harbor, WA 98277-3200
Phone (360) 240-0022

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

Practice roles

OrganizationSpecialtyStatusNew patients
Key to Behavior Behavior Analyst CurrentSince Jul 23, 2023 Accepting new patients
Hope Speech and Language Therapy Behavior Analyst CurrentSince Jul 23, 2023 Accepting new patients
L.E.a.P.S and Beyond, Inc Past Accepting new patients
Hardy and Lukes Physical Therapy, Inc. Behavior Analyst Past Accepting new patients
L.E.a.P.S. and Beyond, Inc Behavior Analyst Past Accepting new patients

Locations

41760 Ivy St
Ste 101
Murrieta, CA 92562
Phone (951) 215-6147

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1083199723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41760 IVY ST STE 101",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629416",
            "telephone_number": "951-595-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41760 IVY ST STE 101",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629416",
            "telephone_number": "951-595-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Leaps and Beyond Inc. 231 SE Barrington Dr. Ste 203",
            "address_purpose": "LOCATION",
            "city": "Oak Harbor",
            "state": "WA",
            "postal_code": "982773200",
            "country_code": "US",
            "telephone_number": "360-240-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZISSIMOS",
        "first_name": "KATELYN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-23-66888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.