Jaime Lyn Fornal, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-10-7086 Issued in CO

Practice address

2224 South Fraiser Street
Unit 6
Aurora, CO 80014

Phone

(720) 584-8055

Fax

(303) 957-2251

NPI assigned

Nov 30, 2012

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": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1952646036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N LAFAYETTE ST",
            "address_2": "# 405",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802183162",
            "telephone_number": "720-470-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 SOUTH FRAISER STREET",
            "address_2": "UNIT 6",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80014",
            "telephone_number": "720-584-8055",
            "fax_number": "303-957-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNAL",
        "first_name": "JAIME",
        "middle_name": "LYN",
        "name_prefix": "Miss",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-10-7086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Forlina, LCSW, MSW
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• Eric John Formeister, M.D., M.S.
• Richard Andrew Forney
• Sharda Fornnarino, RN
• Phylise Seldin Forsberg, PNP-BC
• Kellyn Forsman
• Kylie Elizabeth Forst, MD

• Behavior Analyst in Aurora, CO
• Providers in Aurora, CO by specialty
• Behavior Analyst in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.