Active NPI
Kelly J Miranda
- Behavior Technician
- Los Angeles, CA
National Provider Identifier
1386128908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4322 Wilshire Blvd
Los Angeles, CA 90010-3793 - Phone
- (323) 879-4951
- NPI assigned
- Sep 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
4322 Wilshire Blvd
Los Angeles, CA 90010-3793
Mailing address
3037 Hollister Ave
Los Angeles, CA 90032-2825
Phone (323) 240-8968
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": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1386128908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3037 HOLLISTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900322825",
"telephone_number": "323-240-8968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4322 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103793",
"telephone_number": "323-879-4951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "KELLY",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-19",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.