Jenna Taitano

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

D8084407 Issued in CA

Practice address

32395 Clinton Keith Rd Ste B12
Wildomar, CA 92595-7568

Phone

(951) 200-5532

NPI assigned

Jan 26, 2018

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1316445166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32395 CLINTON KEITH RD STE B12",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957568",
            "telephone_number": "951-200-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32395 CLINTON KEITH RD STE B12",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957568",
            "telephone_number": "951-200-5532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 E Rincon St Ste 219",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928791387",
            "country_code": "US",
            "telephone_number": "714-834-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAITANO",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "D8084407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yeng Tam
• Angel Tamayo
• Tan D. Vu OD, Inc
• Crescent Taylor
• Paul W Taylor, DDS

• Behavior Analyst in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.