Nicole Marie Destefano, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

400 Continental Blvd Ste 6035
El Segundo, CA 90245-5076

Phone

(760) 803-3717

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

Yes

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

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.

• B. Daniel Shabani, Inc.

  • Behavior Analyst
  • Hermosa Beach, CA
  • NPI 1427347988
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1437620689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SLAUSON LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783120",
            "telephone_number": "760-803-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CONTINENTAL BLVD STE 6035",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455076",
            "telephone_number": "760-803-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Derosia
• Khushbu Desai
• Priya Sarin Desai
• Victoria Desimone
• Contessa Destefanis
• Audrey Deth
• Hannah Deutsch
• Suphada Deutz
• Saksham Dev
• Hannah Lynn Deverse

• Behavior Analyst in El Segundo, CA
• Providers in El Segundo, 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 16, 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.

Verify at the official NPI Registry.