Active NPI
Kenisha Calderilla
- Behavior Technician
- Ontario, CA
National Provider Identifier
1194569806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3190 Shelby St Ste B
Ontario, CA 91764-6563 - Phone
- (909) 451-7861
- Fax
- (855) 568-2494
- NPI assigned
- Jun 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
3190 Shelby St Ste B
Ontario, CA 91764-6563
Mailing address
100 N Pacific Coast Hwy Ste 1400
El Segundo, CA 90245-5602
Phone (310) 856-0800
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Frontiers, LLC | Current | Accepting new patients |
Locations
100 N Pacific Coast Hwy
Ste 1400
El Segundo, CA 90245
Phone (310) 304-0532
3190 Shelby St
Ste B
Ontario, CA 91764
Phone (909) 451-7861
Organizations & group practices 1
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.
-
- Behavior Analyst
- Gardena, CA
- NPI 1245539394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1194569806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N PACIFIC COAST HWY STE 1400",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902455602",
"telephone_number": "310-856-0800",
"fax_number": "855-568-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3190 SHELBY ST STE B",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917646563",
"telephone_number": "909-451-7861",
"fax_number": "855-568-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERILLA",
"first_name": "KENISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-19",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.