Individual provider Active NPI

Christian Borromeo, BCBA

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1104394477
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-42338 Issued in CA
Practice address
501 W Broadway
Suite 800
San Diego, CA 92101-3546
Phone
(855) 832-6727
Fax
(772) 675-9100
NPI assigned
Nov 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 CA
Behavior Analyst 103K00000X 1-20-42338 CA Primary

Addresses

Primary practice location

501 W Broadway
Suite 800
San Diego, CA 92101-3546

Mailing address

7108 South Kanner Hwy
Stuart, FL 34997-7462

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": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1104394477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 SOUTH KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY",
            "address_2": "SUITE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013546",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORROMEO",
        "first_name": "CHRISTIAN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-05",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-20-42338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.