Individual provider Active NPI

Kelsey Lynn Cardon, MS, BCBA

  • Behavior Analyst
  • Irvine, CA
National Provider Identifier
1922573005
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-28439 Issued in CA
Practice address
1063 McGaw Ave
Irvine, CA 92614-5505
Phone
(714) 552-2116
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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 1-17-28439 CA Primary

Addresses

Primary practice location

1063 McGaw Ave
Irvine, CA 92614-5505

Mailing address

1063 McGaw Ave Ste 100
Irvine, CA 92614-5554
Phone (714) 552-2116

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1922573005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 MCGAW AVE STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145554",
            "telephone_number": "714-552-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1063 MCGAW AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145505",
            "telephone_number": "714-552-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDON",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-17-28439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.