Individual provider Active NPI

Jazelle Angeline Gallardo

  • Assistant Behavior Analyst
  • West Covina, CA
National Provider Identifier
1346043346
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
4141 S Nogales St Unit A104
West Covina, CA 91792-3057
Phone
(833) 831-8946
NPI assigned
Mar 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 Primary

Addresses

Primary practice location

4141 S Nogales St Unit A104
West Covina, CA 91792-3057

Mailing address

755 E Date St Apt D6
Brea, CA 92821-6618
Phone (562) 900-1562

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": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1346043346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 E DATE ST APT D6",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216618",
            "telephone_number": "562-900-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 S NOGALES ST UNIT A104",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923057",
            "telephone_number": "833-831-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLARDO",
        "first_name": "JAZELLE",
        "middle_name": "ANGELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.