Individual provider Active NPI

Jaylee Rene Kellar

  • Behavior Technician
  • Camarillo, CA
National Provider Identifier
1811563554
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-169805 Issued in CA
Practice address
400 W Ventura Blvd Ste 150
Camarillo, CA 93010-9140
Phone
(805) 383-1497
Fax
(805) 383-1498
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-21-169805 CA Primary

Addresses

Primary practice location

400 W Ventura Blvd Ste 150
Camarillo, CA 93010-9140

Mailing address

400 W Ventura Blvd Ste 150
Camarillo, CA 93010-9140
Phone (805) 383-1497

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Achievementcenterfortherapy.com RABLS Inc
Other URL achievementcenterfortherapy Other

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
RBT-21-169805CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rabls Inc CurrentSince Jul 10, 2022 Accepting new patients
Rabls Inc PastSince Jun 6, 2021 Accepting new patients

Locations

400 W Ventura Blvd
Ste 150
Camarillo, CA 93010
Phone (805) 383-1497

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1811563554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W VENTURA BLVD STE 150",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930109140",
            "telephone_number": "805-383-1497",
            "fax_number": "805-383-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W VENTURA BLVD STE 150",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930109140",
            "telephone_number": "805-383-1497",
            "fax_number": "805-383-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAR",
        "first_name": "JAYLEE",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-21-169805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Achievementcenterfortherapy.com",
            "affiliation": "Y",
            "affiliationName": "RABLS Inc",
            "address_1": "400 W Ventura Blvd Ste 150",
            "city": "Camarillo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930109140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "achievementcenterfortherapy",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "location",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "400 W Ventura Blvd Ste 150",
            "city": "Camarillo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930109140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.