Jose Ventura Campos, LCSW

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3186 Airway Ave Ste a
Costa Mesa, CA 92626-4650

Phone

(714) 881-0427

NPI assigned

Nov 6, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Creative Solutions for Autism, Inc.

  dba Creative Solutions

  • Behavior Analyst
  • Costa Mesa, CA
  • NPI 1851672554
  NPD

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1225672819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 CHICAGO AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072366",
            "telephone_number": "951-465-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 AIRWAY AVE STE A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264650",
            "telephone_number": "714-881-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "JOSE",
        "middle_name": "VENTURA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137216",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "137216",
            "affiliation": "N",
            "address_1": "3186 Airway Ave Ste A",
            "city": "Costa Mesa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926264650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nico Jay Gamayon Camia, RN
• Jasmin Campos Rivera
• Alyssa Guadalupe Campos
• Brian Anthony Campos
• Ixar Campos
• Natalie Campos
• Ricardo Campos
• Michelle Alexis Canady
• Anthony Canales
• Danielle Melina Canant

• Behavior Technician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.