Active NPI
Nicole Marie Destefano, BCBA
- Behavior Analyst
- El Segundo, CA
National Provider Identifier
1437620689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 400 Continental Blvd Ste 6035
El Segundo, CA 90245-5076 - Phone
- (760) 803-3717
- NPI assigned
- Dec 16, 2018
- Last updated
- Dec 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
400 Continental Blvd Ste 6035
El Segundo, CA 90245-5076
Mailing address
1910 Slauson LN
Redondo Beach, CA 90278-3120
Phone (760) 803-3717
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| B. Daniel Shabani, Inc. | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
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": []
}Other providers in El Segundo, CA
Sources for this page
- 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.