Kristeen Marie Succa, MS, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-39682 Issued in CA

Practice address

2665 Park Center Dr Ste D
Simi Valley, CA 93065-6200

Phone

(805) 416-3384

NPI assigned

Apr 6, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Kids Connection Developmental Therapy Center

  • Pediatric Occupational Therapist
  • Simi Valley, CA
  • NPI 1366871808
  NPD

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1780213306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 PARK CENTER DR STE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656200",
            "telephone_number": "805-416-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 PARK CENTER DR STE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656200",
            "telephone_number": "805-416-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCCA",
        "first_name": "KRISTEEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-39682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kristeen@kidsconnectionstherapy.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2665 Park Center Dr Ste D",
            "city": "Simi Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930656200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justin Stout, DMD
• Yael Straus, MD
• Lauren Christine Strickler, DPT
• Shayna Noel Strong
• Melissa Suard
• Jan Suckut, D.C.
• Melanie Suljada, NP
• Maral Pushian Sultanian, LMFT
• Summit Home Health, Inc
• Summit Optometric Eyecare

• Behavior Analyst in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.