Kimberly Clayre Cortes Villavicencio

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-69986 Issued in CA

Practice address

517 Acacia Ave
San Bruno, CA 94066-4221

Phone

(650) 787-6667

NPI assigned

Mar 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hope for Ohana, LLC

  • Behavior Analyst
  • San Bruno, CA
  • NPI 1710752670
  NPD

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1114504917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 ACACIA AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940664221",
            "telephone_number": "408-616-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 ACACIA AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940664221",
            "telephone_number": "650-787-6667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W Ventura Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930109142",
            "country_code": "US",
            "telephone_number": "858-264-5858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2421 Portola Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930038046",
            "country_code": "US",
            "telephone_number": "801-614-2587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORTES VILLAVICENCIO",
        "first_name": "KIMBERLY",
        "middle_name": "CLAYRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-19-92768",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-23-69986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Richardson Cooper II
• Veronica Coppolino
• Lydia Iris Cordonero, MSW INTERN
• Ma Rocle Correa
• Maria Laura Correa
• Ariel Elizabeth Cortes
• Brianna Cosey
• Keziah Maranne Cossid
• Benjamin Cost
• Kathy Cotchett, CMP

• Behavior Analyst in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.