LEGEND HOLMAN (NPI# 1235761172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235761172 |
| Entity Type | Individual |
| Full Name | LEGEND HOLMAN |
| Practice Address |
17750 Fairview Dr Fontana CA 92336-2864 |
| Practice Telephone | 9097467135 |
| Mailing Telephone | 9097467135 |
| Enumeration Date | 2020-02-09 |
| Last Update Date | 2020-02-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
17750 FAIRVIEW DR |
| City | FONTANA |
| State | CA |
| Zip Code | 92336-2864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700361243 | Schmidt and Jefferson Dental Corporation | Dentist | 16944 South Highland Avenue, Ste. 400, Fontana, CA 92336 | 2018-10-01 |
| 1275032658 | Kenitha Pulliam | Behavioral Analyst | 14051 Catalina Ct, Fontana, CA 92336 | 2018-02-12 |
| 1568961183 | Jordan Frailey | Marriage & Family Therapist | 9161 Sierra Ave. Suite 213, Fontana, CA 92336 | 2018-02-09 |
| 1689198905 | Sara Alyssa Lynch | Specialist/Technologist | 7151 Oak Tree Place, Fontana, CA 92336 | 2017-07-28 |
| 1043749526 | Eric Ceasar Parian Lopez | Registered Nurse | 16001 Pfc Paris Montanez Dr., Fontana, CA 92336 | 2017-06-08 |
| 1275065393 | Alyssa Calderon | Marriage & Family Therapist | 14335 Quail Ct, Fontana, CA 92336 | 2017-03-29 |
| 1588029219 | Daisy Maritza Santana | Behavioral Analyst | 16320 Rosa Linda Ln, Fontana, CA 92336 | 2015-12-23 |
| 1407237498 | Natalie Kathleen Herrera | Physician Assistant | 16456 Sierra Lakes Pkwy, Suite 300, Fontana, CA 92336 | 2015-06-15 |
| 1255738241 | Southern California Picc Providers, Inc. | Spec/Tech, Cardiovascular | 5787 Little Shay Dr, Fontana, CA 92336 | 2014-11-19 |
| 1396175758 | Martha C Ajca | Physician Assistant | 17051 Sierra Lakes Parkway, Suite 101, Fontana, CA 92336 | 2013-11-22 |
| Find all providers in zip 92336 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| 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 |
|---|---|---|---|---|
| 1174149454 | Jennifer Nathalie Sandoval-guzman | Behavior Technician | 7490 Concord Ave, Fontana, CA 92336-1707 | 2020-06-22 |
| 1073143277 | Danielle Deguzman | Behavior Technician | 13675 Alexander Ct, Fontana, CA 92336-3902 | 2020-01-16 |
| 1306481486 | Cynthia Duran | Behavior Technician | 17095 Hackberry Ln, Fontana, CA 92337-6885 | 2019-11-12 |
| 1932744331 | Annie Lysaris Bustamante | Behavior Technician | 9027 Ferndale Ave, Fontana, CA 92335-6017 | 2019-11-10 |
| 1528603156 | Kathia Banda | Behavior Technician | 11519 Oak Knoll Ct, Fontana, CA 92337-0138 | 2019-11-07 |
| 1104460013 | Aryana Natalie Cruz | Behavior Technician | 7802 Wasabi Way, Fontana, CA 92336-3122 | 2019-11-04 |
| 1235786120 | Briana Korinna Calderon | Behavior Technician | 11618 Belmonte Rd, Fontana, CA 92337-0908 | 2019-08-24 |
| 1194370726 | Johnny Murcia | Behavior Technician | 14222 Rideout Ct, Fontana, CA 92336-3605 | 2019-08-09 |
| 1376196352 | Kimberly June Hoekwater | Behavior Technician | 16340 Trelaney Rd, Fontana, CA 92337-0807 | 2019-07-19 |
| 1962054528 | Erik I Garcia | Behavior Technician | 4937 Edmonton St, Fontana, CA 92336-0633 | 2019-07-14 |
| Find all providers in FONTANA | ||||
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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.