Blayne Keith Milburn

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-17-38754 Issued in CA

Practice address

1353 N Fuller Ave PH 2
Los Angeles, CA 90046-4996

Phone

(541) 218-7576

Fax

(213) 277-4944

NPI assigned

Mar 29, 2012

Sex

Male

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

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/kairosnw/r4/

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.

• My ABA Services LLC

  • Behavior Analyst
  • Los Angeles, CA
  • NPI 1316577000
  NPD Authorized official
• My ABA Arizona LLC

  • Behavior Analyst
  • Phoenix, AZ
  • NPI 1689474207
  NPD Authorized official
• My ABA Colorado LLC

  • Behavior Analyst
  • Denver, CO
  • NPI 1952196057
  NPD Authorized official
• Kairos

  • Mental Health Counselor
  • Grants Pass, OR
  • NPI 1144651415
  NPD (past)
• Kairos Northwest

  • Mental Illness Community Based Residential Treatment Facility
  • Grants Pass, OR
  • NPI 1366865495
  NPD (past)

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1619243045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 N FULLER AVE PH 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900464996",
            "telephone_number": "541-218-7576",
            "fax_number": "213-277-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 N FULLER AVE PH 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900464996",
            "telephone_number": "541-218-7576",
            "fax_number": "213-277-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBURN",
        "first_name": "BLAYNE",
        "middle_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-17-38754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashkan Milani, DDS
• Hooman Milani, PHARMD, MBA
• Milano Optical
• Peter Kelsey Zakevich Milano, M.D.
• Andre Lamont Milburn, CRNA
• Clint N Milby
• Hannah Milch, M.D.
• Mario Milch, MD
• Amanda Milder
• Oscar Delbert Miles-Smith Jr., PA

• Behavior Technician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.