Individual provider Active NPI

Bennett Gerard Horsley, BCBA

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1477917425
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-21905 Issued in CA
Practice address
5080 Shoreham PL Ste 103
San Diego, CA 92122-5931
Phone
(858) 272-2662
Fax
(858) 272-2661
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-16-21905 CA Primary

Addresses

Primary practice location

5080 Shoreham PL Ste 103
San Diego, CA 92122-5931

Mailing address

5080 Shoreham PL Ste 103
San Diego, CA 92122-5931
Phone (858) 272-2662

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1477917425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SHOREHAM PL STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225931",
            "telephone_number": "858-272-2662",
            "fax_number": "858-272-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 SHOREHAM PL STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225931",
            "telephone_number": "858-272-2662",
            "fax_number": "858-272-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORSLEY",
        "first_name": "BENNETT",
        "middle_name": "GERARD",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-16-21905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.