Deborah Pandullo, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-15745 Issued in CA

Practice address

275 W Hospitality LN # 324
San Bernardino, CA 92408-3249

Phone

(800) 951-9813

NPI assigned

Jan 4, 2019

Last updated

Jan 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1265905996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 CASA GRANDE ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911044105",
            "telephone_number": "626-372-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN # 324",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083249",
            "telephone_number": "800-951-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDULLO",
        "first_name": "DEBORAH",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-14-15745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Palmer
• McKenna Palmer
• Nora Palomera
• Sarah Palomera
• Nyda Corpuz Pamintuan, MD
• Patricia Panfilo
• Donna Panganiban, RDN
• Melanie Paniagua I
• Gabriella Johanna Panjaitan, AMFT
• Kayla Alexis Pankey

• Behavior Analyst in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.