Krysta Danielle Russo, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-39612

Practice address

10442 Yolanda Ave
Porter Ranch, CA 91326-3440

Phone

(818) 419-3068

NPI assigned

Feb 7, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1811529860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10442 YOLANDA AVE",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263440",
            "telephone_number": "818-419-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10442 YOLANDA AVE",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263440",
            "telephone_number": "818-419-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KRYSTA",
        "middle_name": "DANIELLE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-39612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Senior Care, Inc.
• Mojdeh Rouhani, PHARMD
• Royal Recovery and Treatment Center
• Jacob Philip Rubin, MD
• Fredrick Matthew Russo, MD.
• Jacob Hyunwoo Ryang
• Michellene Saegh, M.D.
• Navjot Saggar, FNP
• Sanaa Saquib, PHARMD
• Alaleh Sareh, MD.

• Behavior Analyst in Porter Ranch, CA
• Providers in Porter Ranch, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.