Active NPI
Carlyn L Fontana, BA, MED, BCBA
- Behavior Analyst
- Temecula, CA
National Provider Identifier
1225489651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11622466
- Practice address
- 44146 Calle Ciuita
Temecula, CA 92592-3992 - Phone
- (847) 502-6918
- NPI assigned
- Jun 27, 2016
- Last updated
- Jul 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | 11622466 | CA | Primary |
Addresses
Primary practice location
44146 Calle Ciuita
Temecula, CA 92592-3992
Mailing address
44146 Calle Ciuita
Temecula, CA 92592-3992
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
- Credentials
- Bachelor of Arts, Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11622466 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1225489651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44146 CALLE CIUITA",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925923992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44146 CALLE CIUITA",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925923992",
"telephone_number": "847-502-6918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTANA",
"first_name": "CARLYN",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "BA, MED, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-27",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "11622466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.