Kristen Sophia Mandilas, M.ED., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11622756 Issued in CA

Practice address

15225 Sweet Caddies Dr
Pflugerville, TX 78660-3208

Phone

(716) 982-9096

NPI assigned

Sep 16, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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.

• Qualife, LLC

  • Behavior Analyst
  • Pflugerville, TX
  • NPI 1811496300
  NPD
• Multiplicity Therapeutic Services

  • Community/Behavioral Health Agency
  • Arcata, CA
  • NPI 1124373691
  NPD (past)

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518307200000",
    "number": "1679021844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15225 SWEET CADDIES DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603208",
            "telephone_number": "716-982-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 SWEET CADDIES DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603208",
            "telephone_number": "716-982-9096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Crescent Way",
            "address_purpose": "LOCATION",
            "city": "Arcata",
            "state": "CA",
            "postal_code": "955216741",
            "country_code": "US",
            "telephone_number": "707-822-1136",
            "fax_number": "707-633-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDILAS",
        "first_name": "KRISTEN",
        "middle_name": "SOPHIA",
        "name_prefix": "Ms.",
        "credential": "M.ED., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2018-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11622756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raven Mahatha
• Mohammad Makkouk, MD
• Israel Maldonado, DPT
• Ikram Malik, M.D.
• Deborah Malpica, PHARMD
• Manolo Nino Manliclic
• Richard Mann, PSY.D.
• Charles Mansfield
• Leshawn Manus
• Sangeetha Mariappan, MD

• Behavior Analyst in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2018; 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.