Active NPI
Darryl Tillo
- Behavior Technician
- Eugene, OR
National Provider Identifier
1245993344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- ABA-IN-10215551
- Practice address
- 1142 Willagillespie Rd # 9
Eugene, OR 97401-2142 - Phone
- (541) 666-3652
- NPI assigned
- Oct 16, 2021
- Sex
- Male
- Sole proprietor
- No
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 Technician | 106S00000X | ABA-IN-10215551 | OR | Primary |
Addresses
Primary practice location
1142 Willagillespie Rd # 9
Eugene, OR 97401-2142
Mailing address
1142 Willagillespie Rd Ste 9
Eugene, OR 97401-2142
Phone (541) 666-3652
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
| License | State | Type | Specialty |
|---|---|---|---|
| ABA-IN-10215551 | OR | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634342400000",
"number": "1245993344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1142 WILLAGILLESPIE RD STE 9",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012142",
"telephone_number": "541-666-3652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1142 WILLAGILLESPIE RD # 9",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012142",
"telephone_number": "541-666-3652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLO",
"first_name": "DARRYL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-16",
"last_updated": "2021-10-16",
"certification_date": "2021-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OR",
"license": "ABA-IN-10215551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.