Prism Behavior

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Legal business name

PRISM BEHAVIOR

Practice address

21600 Oxnard St Ste 1030
Woodland Hills, CA 91367-5085

Phone

(818) 493-8318

NPI assigned

Apr 8, 2021

Organization subpart

No

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

Authorized official

Name

Nicole IlaganNPI 1417536913

Title

Behavioral Technican

Phone

(818) 493-8318

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Deotoy Ilagan

  • Day Training/Habilitation Specialist
  • Reseda, CA
  • NPI 1417536913

  Behavior Technician

  NPD Authorized official

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1184204752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1030",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1030",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675085",
            "telephone_number": "818-493-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM BEHAVIOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "ILAGAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BEHAVIORAL TECHNICAN",
        "authorized_official_telephone_number": "818-493-8318"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://pbs.bamboohr.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21600 Oxnard St Ste 1030",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913675085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kwanee A Price-Butler
• Iliana L Pride
• Primespan LLC
• Jessica Prince
• Priority Medical Clinic a Professional Medical Corporation
• Prism Behavioral Solutions
• Prism Behavioral Solutions
• Prism Behavioral Solutions Inc
• Prism Network
• Prisms Consulting Group LLC

• Behavior Technician in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.