Individual provider Active NPI

Jaymee Ann Sambo Simbulan, BCBA

  • Behavior Analyst
  • Orlando, FL
National Provider Identifier
1114436029
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3200 S Hiawassee Rd Ste 203
Orlando, FL 32835-6317
Phone
(407) 600-7463
NPI assigned
Sep 22, 2017
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X FL
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

3200 S Hiawassee Rd Ste 203
Orlando, FL 32835-6317

Mailing address

1056 Nin St
Orlando, FL 32835-5135
Phone (407) 600-7463

Other practice location 1

148 Wilshire Blvd
Casselberry, FL 32707-5372
Phone (321) 972-4039

Other practice location 2

148 Wilshire Blvd
Casselberry, FL 32707-5372
Phone (321) 972-4039

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": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1114436029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 NIN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355135",
            "telephone_number": "407-600-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S HIAWASSEE RD STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356317",
            "telephone_number": "407-600-7463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Casselberry",
            "state": "FL",
            "postal_code": "327075372",
            "country_code": "US",
            "telephone_number": "321-972-4039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "148 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Casselberry",
            "state": "FL",
            "postal_code": "327075372",
            "country_code": "US",
            "telephone_number": "321-972-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMBULAN",
        "first_name": "JAYMEE ANN",
        "middle_name": "SAMBO",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.