Individual provider Active NPI

Kelly Smiland

  • Behavior Analyst
  • Rancho Cucamonga, CA
National Provider Identifier
1154847028
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
10995 Eucalyptus St
Rancho Cucamonga, CA 91730-7686
Phone
(909) 581-6354
Fax
(626) 355-5173
NPI assigned
Aug 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

10995 Eucalyptus St
Rancho Cucamonga, CA 91730-7686

Mailing address

370 W Sierra Madre Blvd Ste B
Sierra Madre, CA 91024-2714
Phone (626) 355-5160

Other practice location 1

370 W Sierra Madre Blvd Ste B
Sierra Madre, CA 91024-2714
Phone (626) 355-5160

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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154847028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 W SIERRA MADRE BLVD STE B",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910242714",
            "telephone_number": "626-355-5160",
            "fax_number": "626-355-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10995 EUCALYPTUS ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307686",
            "telephone_number": "909-581-6354",
            "fax_number": "626-355-5173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 W Sierra Madre Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Sierra Madre",
            "state": "CA",
            "postal_code": "910242714",
            "country_code": "US",
            "telephone_number": "626-355-5160",
            "fax_number": "626-355-5160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMILAND",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.