Active NPI
Taylor Krickbaum
- Behavior Technician
- San Diego, CA
National Provider Identifier
1578254058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-273722
- Practice address
- 501 W Broadway Ste 800
San Diego, CA 92101-3546 - Phone
- (877) 418-2978
- NPI assigned
- May 16, 2023
- Last updated
- Jul 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-273722 | AR | Primary |
Addresses
Primary practice location
501 W Broadway Ste 800
San Diego, CA 92101-3546
Mailing address
501 W Broadway Ste 800
San Diego, CA 92101-3546
Other practice location 1
4610 W Commercial Dr
North Little Rock, AR 72116-7057
Phone (501) 287-5229
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-273722 | AR | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1578254058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 W BROADWAY STE 800",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921013546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W BROADWAY STE 800",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921013546",
"telephone_number": "877-418-2978"
}
],
"practiceLocations": [
{
"address_1": "4610 W Commercial Dr",
"address_purpose": "LOCATION",
"city": "North Little Rock",
"state": "AR",
"postal_code": "721167057",
"country_code": "US",
"telephone_number": "501-287-5229",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRICKBAUM",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2023-07-19",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AR",
"license": "RBT-23-273722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.