Individual provider Active NPI

Dallas Flynn, RADT

  • Behavior Technician
  • Costa Mesa, CA
National Provider Identifier
1194677658
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
R1521850823 Issued in CA
Practice address
1380 Village Way Apt H103
Costa Mesa, CA 92626-4035
Phone
(760) 596-7917
NPI assigned
Feb 9, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X R1521850823 CA Primary

Addresses

Primary practice location

1380 Village Way Apt H103
Costa Mesa, CA 92626-4035

Mailing address

1380 Village Way Apt H103
Costa Mesa, CA 92626-4035
Phone (760) 596-7917

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

State licenses

LicenseStateTypeSpecialty
R1521850823CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1770595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1194677658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 VILLAGE WAY APT H103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264035",
            "telephone_number": "760-596-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 VILLAGE WAY APT H103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264035",
            "telephone_number": "760-596-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "DALLAS",
        "credential": "RADT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "R1521850823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.