Kyshawn Antonio Hill

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11939817 Issued in CA

Practice address

5530 Corbin Ave Ste 221
Tarzana, CA 91356-6095

Phone

(818) 600-8758

Fax

(833) 728-0328

NPI assigned

Aug 3, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1487381075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 CORBIN AVE STE 221",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566095",
            "telephone_number": "818-600-8758",
            "fax_number": "833-728-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 CORBIN AVE STE 221",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566095",
            "telephone_number": "818-600-8758",
            "fax_number": "833-728-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "KYSHAWN",
        "middle_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11939817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.fmbtagency.com",
            "affiliation": "N",
            "endpointDescription": "www.fmbtagency.com",
            "address_1": "5530 Corbin Ave Ste 221",
            "city": "Tarzana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913566095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ines Herrera
• Joe Alexander Herrera, BCBA
• Teresa Lynn Herrera
• Phoenicia Herring
• George Allen Hester, C30231214
• Melissa Hill, MS
• Tracey Hill
• Hillside Hospice
• Janine Himes
• Yesmine Hines

• Behavior Analyst in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.