Individual provider Active NPI

Jillian Mikaela Miranda

  • Assistant Behavior Analyst
  • Gardena, CA
National Provider Identifier
1295460939
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
1411 W 190TH St
Gardena, CA 90248-4324
Phone
(714) 834-1111
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X CA Primary

Addresses

Primary practice location

1411 W 190TH St
Gardena, CA 90248-4324

Mailing address

1411 W 190TH St
Gardena, CA 90248-4324
Phone (714) 834-1111

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1295460939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W 190TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484324",
            "telephone_number": "714-834-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W 190TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484324",
            "telephone_number": "714-834-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JILLIAN",
        "middle_name": "MIKAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.