Rose D Kelley, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-75581 Issued in CA

Practice address

11650 Iberia PL
San Diego, CA 92128-2406

Phone

(858) 264-5858

Fax

(858) 649-6012

NPI assigned

Aug 30, 2022

Last updated

Sep 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1285354365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 IBERIA PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282406",
            "telephone_number": "858-264-5858",
            "fax_number": "858-649-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 IBERIA PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282406",
            "telephone_number": "858-264-5858",
            "fax_number": "858-649-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ROSE",
        "middle_name": "D",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-24-75581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leon R Kelley, MD
• Lynne A Kelley, LCSW
• Maria Teresa Kelley, LCSW
• Mary Virginia Kelley, PT
• Michael L Kelley, RN, BSN, IBCLC
• Sara Marciadene Kelley, JD
• Shena Kelley
• Walter Benton Kelley III
• Lisa Kelllum, RN BSN PHN
• Allyson R Kellmer, BCBA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.