KAYLAVICTORIA OBAMWONYI (NPI# 1093193021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093193021 |
| Entity Type | Individual |
| Full Name | KAYLAVICTORIA OBAMWONYI |
| Practice Address |
124 Capulet Dr St Augustine FL 32092-4537 |
| Mailing Address |
175 Middle St Unit 1201 Lake Mary FL 32746-3625 |
| Practice Telephone | 9044293859 |
| Mailing Telephone | 8666100580 |
| Mailing Fax Number | 4075886294 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2019-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 106E00000X | Assistant Behavior Analyst | 0-17-8157 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 100149700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12276 San Jose Blvd, Ste 508, Jacksonville, FL 322238628 | 9048863228 | 9048863297 |
| Street Address |
124 CAPULET DR |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32092-4537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134827 | Erin Holtz | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2020-11-02 |
| 1356955397 | Thomas Goldstein | Psychologist | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2020-09-08 |
| 1598321135 | Synethia Brown | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2019-05-18 |
| 1700345329 | Serena Cecere | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2019-03-13 |
| 1649751769 | Jessica Rodriguez | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2018-08-27 |
| 1588142582 | Lauren Elizabeth Stuckey | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2018-08-01 |
| 1316444847 | Coleen Wysocki | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2018-04-11 |
| 1376048355 | Jessica Suarez | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2018-03-29 |
| 1174023386 | Bridget R Stanton | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2018-02-14 |
| 1750899589 | Caitlin Owen Russell | Behavior Technician | 124 Capulet Dr, St Augustine, FL 32092-4537 | 2018-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670146 | Kaitlyn Thomas | Speech-Language Pathologist | 111 Nature Walk Pkwy # B101, Saint Augustine, FL 32092 | 2019-07-10 |
| 1386168359 | Westminster Pines, Inc. | Skilled Nursing Facility | 235 Towerview Drive, St. Augustine, FL 32092 | 2017-08-01 |
| 1255852471 | St Vincent's Urgent Care Inc | Clinic/Center | 2001 Country Road 210 West, St Augustine, FL 32092 | 2017-06-28 |
| 1649702291 | Leonard Volpe | Physician Assistant | 745 Porta Rosa Cir, St Augustine, FL 32092 | 2017-04-03 |
| 1740630425 | Sierra Danielle Shultz | Behavioral Analyst | 2590 C H Arnold Rd, Saint Augustine, FL 32092 | 2016-06-14 |
| 1023467347 | Marylin Palackel James | Family Medicine | 110 Hampton Point Dr, St Augustine, FL 32092 | 2016-06-07 |
| 1790146462 | Florida Autism Center | Community/Behavioral Health | 124 Capulet Drive, St Augustine, FL 32092 | 2016-03-09 |
| 1174901458 | Kaylan Brady | Pediatrics | 70 Turin Terrace, Suite 220, St Augustine, FL 32092 | 2015-05-07 |
| 1245620368 | Angela Sanchez | Physician Assistant | 229 Adelanto Ave, St Augustine, FL 32092 | 2015-01-27 |
| 1053723700 | David Hamilton | Dentist | 149 Tuscan Way, St. Augustine, FL 32092 | 2014-05-29 |
| Find all providers in zip 32092 | ||||
| Taxonomy Code | 106E00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Assistant Behavior Analyst |
| An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750923249 | Patrick Raymond Sparks | Assistant Behavior Analyst | 2101 Arc Dr, St Augustine, FL 32084-0512 | 2019-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992305924 | Irialis Gonzalez Gutierrez | Assistant Behavior Analyst | 6261 W Flagler St Apt 22, Miami, FL 33144-3024 | 2020-10-28 |
| 1265031157 | Raquel Daetz Garcia | Assistant Behavior Analyst | 11262 Sw 230th Ter, Miami, FL 33170-7612 | 2020-10-21 |
| 1790383149 | Jorge L Hernandez Aguilar | Assistant Behavior Analyst | 14236 Sw 91st St, Miami, FL 33186-7802 | 2020-10-16 |
| 1114525839 | Stepping Stones Supports LLC | Assistant Behavior Analyst | 5221 Nw 81st Ter, Lauderhill, FL 33351-5050 | 2020-10-14 |
| 1912505884 | Maria Matilde Alonso Urquijo | Assistant Behavior Analyst | 7317 Sw 22nd St, Miami, FL 33155-1426 | 2020-10-13 |
| 1093312647 | Rody Blanco | Assistant Behavior Analyst | 18512 Field Club Way, Tampa, FL 33647-1823 | 2020-10-07 |
| 1699372870 | Karen Zhao | Assistant Behavior Analyst | 8303 Sw 107th Ave Apt A, Miami, FL 33173-3805 | 2020-10-01 |
| 1508473802 | Camryn Nichole White | Assistant Behavior Analyst | 301 South Florida Ave, Lakeland, FL 33801 | 2020-09-30 |
| 1689281453 | Betsy Escobar Lozada | Assistant Behavior Analyst | 601 Ludlam Dr Apt 1, Miami Springs, FL 33166-4971 | 2020-09-25 |
| 1710593991 | Odalis De Las Mercedes Marrero | Assistant Behavior Analyst | 6502 Blue Ribbon Ln Apt 301, Tampa, FL 33625-2480 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32092 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.