Individual provider Active NPI

Davon Kittles

  • Behavior Technician
  • Rancho Cucamonga, CA
National Provider Identifier
1225799331
Registry record updated Jan 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
9600 Center Ave
Rancho Cucamonga, CA 91730-5838
Phone
(858) 264-5858
NPI assigned
Jan 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2022

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 Primary

Addresses

Primary practice location

9600 Center Ave
Rancho Cucamonga, CA 91730-5838

Mailing address

PO Box 8544
Pasadena, CA 91109-8602

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

NPI Registry JSON

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

{
    "created_epoch": "1641081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641081600000",
    "number": "1225799331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8544",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911098602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 CENTER AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305838",
            "telephone_number": "858-264-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTLES",
        "first_name": "DAVON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-02",
        "last_updated": "2022-01-02",
        "certification_date": "2022-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; 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.