Individual provider Active NPI

Tara Gallison, BCABA

  • Assistant Behavior Analyst
  • San Diego, CA
National Provider Identifier
1720326424
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-10-3861 Issued in CA
Practice address
3731 6TH Ave Ste 100
San Diego, CA 92103-4383
Phone
(619) 278-0884
NPI assigned
Jan 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-10-3861 CA Primary

Addresses

Primary practice location

3731 6TH Ave Ste 100
San Diego, CA 92103-4383

Mailing address

3731 6TH Ave Ste 100
San Diego, CA 92103-4383
Phone (619) 278-0884

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

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1720326424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3731 6TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034383",
            "telephone_number": "619-278-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 6TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034383",
            "telephone_number": "619-278-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLISON",
        "first_name": "TARA",
        "credential": "BCABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CA",
            "license": "0-10-3861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.