Individual provider Active NPI

Eileen Pena Ceballo

  • Behavior Analyst
  • Homestead, FL
National Provider Identifier
1568915908
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-51844 Issued in FL
Practice address
1671 SE 30TH St
Homestead, FL 33035-2360
Phone
(786) 728-2520
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 1-21-51844 FL Primary

Addresses

Primary practice location

1671 SE 30TH St
Homestead, FL 33035-2360

Mailing address

1671 SE 30TH St
Homestead, FL 33035-2360
Phone (786) 728-2520

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1568915908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 SE 30TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330352360",
            "telephone_number": "786-728-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 SE 30TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330352360",
            "telephone_number": "786-728-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA CEBALLO",
        "first_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-51844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.