Active NPI
Michelle Kadlac
- Behavior Analyst
- San Diego, CA
National Provider Identifier
1649898735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB538023
- Practice address
- 5755 Oberlin Dr Ste 300
San Diego, CA 92121-4717 - Phone
- (800) 249-1266
- NPI assigned
- Jul 6, 2020
- Last updated
- May 7, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB538023 | CA | |
| Behavior Analyst | 103K00000X | BACB538023 | CA | Primary |
Addresses
Primary practice location
5755 Oberlin Dr Ste 300
San Diego, CA 92121-4717
Mailing address
1301 E Orangewood Ave
Anaheim, CA 92805-6807
Phone (800) 249-1266
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 |
|---|---|---|---|
| BACB538023 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| True Crew California LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1649898735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 E ORANGEWOOD AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928056807",
"telephone_number": "800-249-1266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5755 OBERLIN DR STE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921214717",
"telephone_number": "800-249-1266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KADLAC",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-06",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "BACB538023",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "BACB538023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
- Kadash Global Resources LLC (KGR LLC)
- Andrew John Kaddis, M.D.
- Kadence Healthcare, Inc.
- Andrew Karim Abdel Kader, MD
- Maggie M Kading, RDH
- Richard Preston Kadota, M.D.
- Melissa Bess Kae, PSYD
- David Maurer Kaegi, M.D.
- Kaelyn Marie Licensed Professional Clinical Counselor Inc
- Edward Preston Kaenel, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.