Active NPI
William Gibbon
- Behavior Technician
- Gardena, CA
National Provider Identifier
1932602695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 18-49559
- Practice address
- 879 W 190TH St Ste 1000
Gardena, CA 90248-4255 - Phone
- (310) 329-9115
- Fax
- (209) 572-1461
- NPI assigned
- Mar 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 18-49559 | CA | Primary |
Addresses
Primary practice location
879 W 190TH St Ste 1000
Gardena, CA 90248-4255
Mailing address
879 W 190TH St Ste 1000
Gardena, CA 90248-4255
Phone (310) 329-9115
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18-49559 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753920000000",
"number": "1932602695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "879 W 190TH ST STE 1000",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484255",
"telephone_number": "310-329-9115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "879 W 190TH ST STE 1000",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484255",
"telephone_number": "310-329-9115",
"fax_number": "209-572-1461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBON",
"first_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-08",
"last_updated": "2025-07-31",
"certification_date": "2025-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "18-49559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.