Individual provider Active NPI

Jessica Nicolosi

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1487057451
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
501 W Broadway Ste 800
San Diego, CA 92101
Phone
(888) 880-9270
Fax
(954) 342-0273
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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 Primary

Addresses

Primary practice location

501 W Broadway Ste 800
San Diego, CA 92101

Mailing address

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817

Other practice location 1

501 W Broadway Ste 800
San Diego, CA 92101
Phone (888) 880-9270

Other practice location 2

501 W Broadway Ste 800
San Diego, CA 92101
Phone (888) 880-9270

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1487057451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FAIRWAY DR STE 102",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101",
            "telephone_number": "888-880-9270",
            "fax_number": "954-342-0273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W Broadway Ste 800",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92101",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "fax_number": "954-342-0273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W Broadway Ste 800",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92101",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "fax_number": "954-342-0273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLOSI",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "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 Oct 31, 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.