Active NPI
Kailynn Grace Ann Moline, RBT
- Behavior Technician
- Mountain View, CA
National Provider Identifier
1104432236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-131475
- Practice address
- 1134 W El Camino Real
Mountain View, CA 94040-2518 - Phone
- (855) 223-7123
- Fax
- (317) 520-8200
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-131475 | IN | Primary |
Addresses
Primary practice location
1134 W El Camino Real
Mountain View, CA 94040-2518
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (619) 550-6368
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-131475 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopebridge, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
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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Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614902400000",
"number": "1104432236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16782 VON KARMAN AVE STE 11",
"city": "IRVINE",
"state": "CA",
"postal_code": "926062417",
"telephone_number": "619-550-6368",
"fax_number": "317-520-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1134 W EL CAMINO REAL",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940402518",
"telephone_number": "855-223-7123",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLINE",
"first_name": "KAILYNN",
"middle_name": "GRACE ANN",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-23",
"last_updated": "2021-03-05",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-20-131475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain View, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.