Individual provider Active NPI

Keri O'Callaghan

  • Behavior Analyst
  • Fresno, CA
National Provider Identifier
1568900702
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-24163 Issued in CA
Practice address
5168 N Blythe Ave Ste 102
Fresno, CA 93722-6478
Phone
(559) 255-5900
Fax
(559) 981-1212
NPI assigned
Feb 8, 2017
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 1-16-24163 CA Primary

Addresses

Primary practice location

5168 N Blythe Ave Ste 102
Fresno, CA 93722-6478

Mailing address

5850 Granite Pkwy Ste 600
Plano, TX 75024-6753
Phone (469) 694-1754

Other practice location 1

1915 Howard Rd Ste B&c
Madera, CA 93637-5163
Phone (559) 330-2211

Other practice location 2

1420 Shaw Ave Ste 105
Clovis, CA 93611-4072
Phone (559) 314-0623

Other practice location 3

2808 Park Ave Ste A
Merced, CA 95348-3392
Phone (209) 308-5009

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Autism and Related Disorders LLC Behavior Analyst CurrentSince Sep 11, 2022 Accepting new patients
Center for Autism & Related Disorders, LLC Behavior Analyst CurrentSince Aug 14, 2022 Accepting new patients

Locations

21600 Oxnard St
Ste 1800
Woodland Hls, CA 91367
Phone (813) 345-2345

5850 Granite Pkwy
Ste 600
Plano, TX 75024
Phone (425) 426-2761

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1568900702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 GRANITE PKWY STE 600",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246753",
            "telephone_number": "469-694-1754",
            "fax_number": "818-758-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5168 N BLYTHE AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937226478",
            "telephone_number": "559-255-5900",
            "fax_number": "559-981-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1915 Howard Rd Ste B&c",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936375163",
            "country_code": "US",
            "telephone_number": "559-330-2211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Shaw Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936114072",
            "country_code": "US",
            "telephone_number": "559-314-0623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2808 Park Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953483392",
            "country_code": "US",
            "telephone_number": "209-308-5009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CALLAGHAN",
        "first_name": "KERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-16-24163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.