Makenzie Jo Daris, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-34353 Issued in TX

Practice address

3020 Childrens Way
San Diego, CA 92123-4223

Phone

(858) 966-8555

NPI assigned

Jun 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mebe San Diego

  • Behavior Analyst
  • San Diego, CA
  • NPI 1811336910
  NPD (past)
• Mebe Speech and Language Pathology Inc.

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1649834888
  NPD (past)
• Action Behavior Centers, LLC

  • Behavior Analyst
  • Arvada, CO
  • NPI 1659194686
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1649830100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2888 Loker Ave E Ste 105",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920106683",
            "country_code": "US",
            "telephone_number": "619-578-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARIS",
        "first_name": "MAKENZIE",
        "middle_name": "JO",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-18-34353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB CERTIFICATION NUMBER",
            "identifier": "1-18-34353",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Darchuck
• Bernadette Dardaine, AMFT
• Vanessa Nicole Darden
• Jenae Dareing
• Shirley Ann Darensburg
• Kristen S Darji, NNP
• Sasha Darkus
• Darlene Tando Licensed Clinical Social Worker Apc
• Spencer Darlin
• Bethany Darling, M.D.

• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.