Jeremy Tadrous, M.S., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1774 Issued in MA

Practice address

1664 Broadway
El Cajon, CA 92021-5201

Phone

(619) 579-8685

NPI assigned

Jul 20, 2017

Sex

Male

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1174046239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215201",
            "telephone_number": "201-835-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215201",
            "telephone_number": "619-579-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADROUS",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-20",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.