Charmin Rose Gentry, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-62808

Practice address

2820 Camino del Rio S Ste 100
San Diego, CA 92108-3822

Phone

(800) 434-8923

Fax

(615) 905-9200

NPI assigned

Jul 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• ABA Education Foundation

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1720480320
  NPD (past)

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1194248773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 CAMINO DEL RIO S STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083822",
            "telephone_number": "800-434-8923",
            "fax_number": "615-905-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 CAMINO DEL RIO S STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083822",
            "telephone_number": "800-434-8923",
            "fax_number": "615-905-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W Broadway Ste 800",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921013546",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7860 Mission Center Ct Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921081330",
            "country_code": "US",
            "telephone_number": "619-272-0090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "CHARMIN ROSE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-22-62808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD, INC. (BACB)",
            "identifier": "0-17-7794",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD, INC. (BACB)",
            "identifier": "1-22-62808",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.