Individual provider Active NPI

Kamila Iacob

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1982133690
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-39747 Issued in CA
Practice address
3111 Camino del Rio N
San Diego, CA 92108-5720
Phone
(310) 856-0800
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 1-19-39747 CA Primary

Addresses

Primary practice location

3111 Camino del Rio N
San Diego, CA 92108-5720

Mailing address

100 N Pacific Coast Hwy Ste 1400
El Segundo, CA 90245-5602

Other practice location 1

9245 Activity Rd Ste 106
San Diego, CA 92126-4442
Phone (858) 428-0222

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

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1982133690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N PACIFIC COAST HWY STE 1400",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 CAMINO DEL RIO N",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085720",
            "telephone_number": "310-856-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9245 Activity Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921264442",
            "country_code": "US",
            "telephone_number": "858-428-0222",
            "fax_number": "847-348-3706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACOB",
        "first_name": "KAMILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-39747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.