Eduardo Cedillo, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-67319 Issued in TX

Practice address

700 N Saint Marys St Ste 1400
San Antonio, TX 78205-3535

Phone

(847) 465-9556

NPI assigned

Jun 14, 2021

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

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.

• Funtastic Gymnastic LLC

  • Behavior Analyst
  • Lombard, IL
  • NPI 1396078275
  NPD

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1962070151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 OAK CREEK DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486408",
            "telephone_number": "847-465-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N SAINT MARYS ST STE 1400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782053535",
            "telephone_number": "847-465-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDILLO",
        "first_name": "EDUARDO",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-23-67319",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Henry Rojas Cedeno, MD
• Esteban Alfredo Cedillo-Couvert, MD
• Alyssa Marie Cedillo, M.A., LPC
• Anna Alexandra Cedillo, APRN-CNP
• Chastina Cedillo
• Elizabeth Cedillo
• Christina Patricia Cefaldo, M.A. CCC-SLP
• Cynthia Celaya-Hernandez, FNP
• Cele Oliver DDS PLLC
• Cele Pokorney DDS PLLC

• Behavior Analyst in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.