Michelle Pellegrino, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-10-7241 Issued in CA

Practice address

15720 Ventura Blvd Ste 403
Encino, CA 91436-2997

Phone

(818) 788-2388

Fax

(818) 788-3875

NPI assigned

Feb 26, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child Counseling & Behavior Therapy Clinic

  • Community/Behavioral Health Agency
  • Encino, CA
  • NPI 1710233705
  NPD (past)

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1558601633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD STE 403",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362997",
            "telephone_number": "818-788-2388",
            "fax_number": "818-788-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD STE 403",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362997",
            "telephone_number": "818-788-2388",
            "fax_number": "818-788-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "MICHELLE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-10-7241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Gastroenterology Medical Center, Inc.
• Panthea Pedoeim, NP
• Michael Pedram, DDS, MD
• Frida Danitza Peinado
• Ifat Peled, PHD
• Howard L Pelta, DC
• Jenny Louise Pendleton, M.F.T.
• Alfred Penhaskashi, DDS
• Jessica C Penley
• Arielle Linda Penn, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.