Diana Kim, BACHELORS

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

RBT-18-51927 Issued in CA

Practice address

1115 14TH St
Modesto, CA 95354-1003

Phone

(209) 572-2589

NPI assigned

Mar 29, 2018

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1295230316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 WHITTLE CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953513461",
            "telephone_number": "209-678-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 14TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541003",
            "telephone_number": "209-572-2589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Whittle Ct",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953513461",
            "country_code": "US",
            "telephone_number": "209-678-4385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DIANA",
        "credential": "BACHELORS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": "18-51927",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": "RBT-18-51927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Killian
• Sonia Alese Killsgard, CMT, B.S. KINSIOLOGY
• Callia Ashley Kim
• Chaemin Kim
• David Kim, BCBA
• Eugene H. Kim, DO
• Hwan Y Kim, MD
• Jung Mee Kim, DDS
• Myung Kim, MD
• Peter Kim, DDS

• Assistant Behavior Analyst in Modesto, CA
• Providers in Modesto, CA by specialty
• Assistant Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.