Kimiye Ibello

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-13-13884 Issued in CA

Practice address

505 E Commonwealth Ave
Fullerton, CA 92832-4009

Phone

(714) 773-0077

NPI assigned

Jul 11, 2013

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

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.

• Sage Behavior Services, Inc

  • Behavior Analyst
  • Fullerton, CA
  • NPI 1598998460
  NPD (past)

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1689015224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N HARBOR BLVD # 124",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928324009",
            "telephone_number": "714-773-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBELLO",
        "first_name": "KIMIYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-13-13884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maximiliano Hyon, D.O.
• Younghee Hyu, NP
• James B Hyun, PHARMD
• Natalie Ibarra
• Susana Ibarra
• Armia Fayez Ibrahim
• Germaine Ibrahim, MD
• Sally Shoukry Ageeb Ibrahim
• Samah Mohamed Ibrahim, RPH
• Gabriel P Ignacio, DPT

• Behavior Analyst in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; 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.