Jacob Phillips

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

17421 Lido LN
Huntington Beach, CA 92647-6143

Phone

(714) 307-2309

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: jphillips@corticacare.com

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1164092698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17421 LIDO LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476143",
            "telephone_number": "714-307-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17421 LIDO LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476143",
            "telephone_number": "714-307-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JPhillips@corticacare.com",
            "affiliation": "Y",
            "affiliationName": "Cortica Behavioral Health Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7090 Miratech Dr",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921213109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philipson Chiropractic Corporation
• Phillip D. Brown D.C., a.P.C.
• Danielle Phillipps, RD
• Amanda Kay Phillips, RN, CPN
• Christina Elisabeth Phillips, PA-C
• Mark Steven Phillips, PHARMD
• Linda Pho
• Deborah Phon
• Phong Thien Vu, M.D., Inc.
• Christianne M. Phu, D.D.S.

• Behavior Analyst in Huntington Beach, CA
• Providers in Huntington Beach, 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 28, 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.

Verify at the official NPI Registry.