Individual provider Active NPI

Nicole Benedicto Murillo, PH.D., BCBA

  • Behavior Analyst
  • Los Angeles, CA
National Provider Identifier
1578697132
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-36278 Issued in CA
Practice address
5777 W Century Blvd Ste 675
Los Angeles, CA 90045-5632
Phone
(310) 649-0499
Fax
(310) 649-3109
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY25017 CA
Behavior Analyst 103K00000X 1-19-36278 CA Primary

Addresses

Primary practice location

5777 W Century Blvd Ste 675
Los Angeles, CA 90045-5632

Mailing address

5777 W Century Blvd Ste 675
Los Angeles, CA 90045-5632
Phone (310) 649-0499

Other practice location 1

6 Venture Ste 350
Irvine, CA 92618-7350
Phone (949) 829-1839

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25017CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lovaas Institute for Early Intervention Behavior Analyst Past Accepting new patients
Institute for Applied Behavior Analysis Behavior Analyst PastSince Jun 27, 2021 Accepting new patients
Lovaas Institute for Early Intervention Behavior Analyst Past Accepting new patients
Patterns Behavioral Services, Inc. Behavior Analyst Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1578697132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD STE 675",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-649-0499",
            "fax_number": "310-649-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD STE 675",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-649-0499",
            "fax_number": "310-649-3109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Venture Ste 350",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926187350",
            "country_code": "US",
            "telephone_number": "949-829-1839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURILLO",
        "first_name": "NICOLE",
        "middle_name": "BENEDICTO",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25017",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-36278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.