Individual provider Active NPI

Iliana Lorena Prieto

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1790474369
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3878 Ruffin Rd Ste B
San Diego, CA 92123-1842
Phone
(619) 739-4569
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 Primary

Addresses

Primary practice location

3878 Ruffin Rd Ste B
San Diego, CA 92123-1842

Mailing address

4492 Camino de la PLZ # 2213
San Ysidro, CA 92173-3071

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1790474369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4492 CAMINO DE LA PLZ # 2213",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921733071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3878 RUFFIN RD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231842",
            "telephone_number": "619-739-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO",
        "first_name": "ILIANA",
        "middle_name": "LORENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "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 May 1, 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.

Verify at the official NPI Registry.