Lissette Gamboa, LMHC, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-41535 Issued in FL

Practice address

13195 SW 134TH St Ste 201
Miami, FL 33186-4585

Phone

(786) 206-6500

NPI assigned

Aug 16, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1861918393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 SW 132ND AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275432",
            "telephone_number": "305-494-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST STE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864585",
            "telephone_number": "786-206-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5437 SW 132nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330275432",
            "country_code": "US",
            "telephone_number": "305-494-1902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "LISSETTE",
        "name_prefix": "Mrs.",
        "credential": "LMHC, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15245",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-20-41535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Gamboa Pena
• Amalia Gamboa Rueda
• Amely Gamboa
• Heidi Gamboa, D.O.
• Kirel Gamboa
• Luke Aaron Gamboa, RBT
• Maria Jose Gamboa
• Marylena Gamboa
• Marylu Gamboa
• Nataly Gamboa

• Behavior Analyst in Miami, FL
• Providers in Miami, FL by specialty
• Behavior Analyst in Florida

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