Active NPI
Kaitlyn Peterson
- Behavior Technician
- Ontario, CA
National Provider Identifier
1760258891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1500 S Haven Ave Ste 250
Ontario, CA 91761-2973 - Phone
- (909) 749-5204
- NPI assigned
- Nov 29, 2023
- Last updated
- Nov 29, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
1500 S Haven Ave Ste 250
Ontario, CA 91761-2973
Mailing address
564 Converse Ave
Claremont, CA 91711-5534
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Genius LLC | Behavior Technician | Current | Accepting new patients |
Locations
1500 S Haven Ave
Ste 250
Ontario, CA 91761
Phone (888) 928-8860
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": "1701216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1760258891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "564 CONVERSE AVE",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917115534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 S HAVEN AVE STE 250",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917612973",
"telephone_number": "909-749-5204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "KAITLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-29",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.