Individual provider Active NPI

Keith Andrew Gregorie

  • Behavior Technician
  • Carlsbad, CA
National Provider Identifier
1407615115
Registry record updated Jul 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2141 Palomar Airport Rd Ste 350
Carlsbad, CA 92011-1451
Phone
(760) 710-2460
Fax
(855) 864-1491
NPI assigned
Mar 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

2141 Palomar Airport Rd Ste 350
Carlsbad, CA 92011-1451

Mailing address

2497 Moonlight GLN
Escondido, CA 92026-3850
Phone (760) 717-6404

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": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753574400000",
    "number": "1407615115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2497 MOONLIGHT GLN",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920263850",
            "telephone_number": "760-717-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 PALOMAR AIRPORT RD STE 350",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111451",
            "telephone_number": "760-710-2460",
            "fax_number": "855-864-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORIE",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-15",
        "last_updated": "2025-07-27",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

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