Mary Jeness Ganguli, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

338 Via Vera Cruz Ste 130
San Marcos, CA 92078-2645

Phone

(866) 727-8274

NPI assigned

Feb 24, 2017

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

Other names 1

• Mary Jeness Keddy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kyo Autism Therapy, LLC

  • Community/Behavioral Health Agency
  • Daly City, CA
  • NPI 1720212749

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1396285318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 VIA VERA CRUZ STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782645",
            "telephone_number": "866-727-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 VIA VERA CRUZ STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782645",
            "telephone_number": "866-727-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGULI",
        "first_name": "MARY",
        "middle_name": "JENESS",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KEDDY",
            "middle_name": "JENESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Gall, RN
• Martha Gallo
• Maria Ysela Galvan-Dupree, MFTI
• Stephanie Galvez
• Doreatha Yvonne Gandy-Edmundson, LCSW
• Kaitlyn Ganley
• Breanne Gannaway
• Ashley Garber, D.P.T.
• John Donald Garbrecht, DPT
• Gail Garcellano, RN

• Behavior Analyst in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.