Jose Angel Portillo, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-59469 Issued in CA

Practice address

21515 Hawthorne Blvd # GL-100
Torrance, CA 90503-6501

Phone

(424) 571-2618

NPI assigned

Aug 18, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4

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.

• Cortica Healthcare Inc

  dba Pediatric Neurology Therapeutics PC

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1801288535
  NPD (past)

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1538715230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 ORCHARD AVE APT 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900071276",
            "telephone_number": "213-220-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21515 HAWTHORNE BLVD # GL-100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036501",
            "telephone_number": "424-571-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "JOSE",
        "middle_name": "ANGEL",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-18",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-22-59469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Brown Porter, PSY.D.
• Leslie Gayle Porter
• Mariana Yareli Portilla
• Bryant Portillo
• Emily Michelle Portillo
• Natalie Portillo
• Ana Stephanie Portka, MS
• Dina Janet Posey, LMFT
• Gladys Postadjian, LCSW
• Albert George Potash, MA MFT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.