Elissa Collins, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-28035 Issued in CA

Practice address

310 3Rd Ave Ste B8
Chula Vista, CA 91910-3990

Phone

(619) 977-6851

NPI assigned

Nov 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1619211141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33568",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633568",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 3RD AVE STE B8",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103990",
            "telephone_number": "619-977-6851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2928 Jefferson St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920082374",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5333 Mission Center Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921081347",
            "country_code": "US",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ELISSA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-17-28035",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": "0-12-5112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.