Individual provider Active NPI

Kelly Majestic

  • Behavior Analyst
  • San Francisco, CA
National Provider Identifier
1780084855
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11416182 Issued in CA
Practice address
36 Monterey Blvd # a
San Francisco, CA 94131-3235
Phone
(877) 264-6747
NPI assigned
Aug 26, 2014
Last updated
Aug 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 11416182 CA Primary

Addresses

Primary practice location

36 Monterey Blvd # a
San Francisco, CA 94131-3235

Mailing address

36 Monterey Blvd # a
San Francisco, CA 94131-3235
Phone (877) 264-6747

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

LicenseStateTypeSpecialty
11416182CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Kyo Autism Therapy, 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": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1780084855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MONTEREY BLVD # A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941313235",
            "telephone_number": "877-264-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MONTEREY BLVD # A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941313235",
            "telephone_number": "877-264-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAJESTIC",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11416182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.