Kalkidan Desta

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

400 E Pratt St FL 8
Baltimore, MD 21202-3180

Phone

(833) 599-2560

NPI assigned

Dec 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1124730163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 TOWBIN AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015928",
            "telephone_number": "833-599-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PRATT ST FL 8",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023180",
            "telephone_number": "833-599-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTA",
        "first_name": "KALKIDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suneetha Desiraju, M.D.
• Marco Desousa
• Lynn Desrosiers, FNP-C
• Lulit Negash Dessie, MD
• Sandy Dessources
• Erica Debra Destefano
• Marielle Destefano, PA-C
• Kisha Destin, MD
• Judy M Destouet, MD
• Barbara Detrick, PHD

• Behavior Technician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Behavior Technician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.