Individual provider Active NPI

Teagen Fox Horn-Tollack

  • Assistant Behavior Analyst
  • Phelan, CA
National Provider Identifier
1205748225
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
Y1934747 Issued in CA
Practice address
4343 Sunnyslope Rd
Phelan, CA 92371-8664
Phone
(760) 221-6984
NPI assigned
Sep 22, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Y1934747 CA Primary

Addresses

Primary practice location

4343 Sunnyslope Rd
Phelan, CA 92371-8664

Mailing address

4343 Sunnyslope Rd
Phelan, CA 92371-8664
Phone (760) 221-6984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1205748225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SUNNYSLOPE RD",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "923718664",
            "telephone_number": "760-221-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SUNNYSLOPE RD",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "923718664",
            "telephone_number": "760-221-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN-TOLLACK",
        "first_name": "TEAGEN",
        "middle_name": "FOX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": "Y1934747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phelan, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.