BRIAN J CARRILLO (NPI# 1245590678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245590678 |
| Entity Type | Individual |
| Full Name | BRIAN J CARRILLO |
| Practice Address |
18726 S Western Ave Ste 408 Gardena CA 90248-3858 |
| Practice Telephone | 3108560800 |
| Practice Fax Number | 8555682494 |
| Mailing Telephone | 3108560800 |
| Mailing Fax Number | 8555682494 |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| Y | 106S00000X | Behavior Technician | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 714 W Main St, Grass Valley, CA 959456410 | 5304779800 | 5304779803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227542 | Brian Carrillo | Respiratory Therapist, Registered | 2051 Marengo St, Los Angeles, CA 90033-1352 | 2020-05-18 |
| 1538517776 | Brian Anthony Carrillo | Physician Assistant | 4445 Magnolia Ave, Riverside, CA 92501-4135 | 2016-05-27 |
| Street Address |
18726 S WESTERN AVE STE 408 |
| City | GARDENA |
| State | CA |
| Zip Code | 90248-3858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386926442 | Diana V Betsis | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2011-09-15 |
| 1700367380 | Kimberly Acebedo | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2018-08-22 |
| 1043728959 | Yea Na Kim | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2018-01-12 |
| 1770016255 | Melissa Vazquez | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2017-04-11 |
| 1043673130 | Elizabeth Garcia | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2016-04-05 |
| 1427477389 | Stacy Sugawara | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2014-04-08 |
| 1003246059 | Taeja Kluge | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2013-11-12 |
| 1427397330 | Nikol Manes | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2013-02-12 |
| 1194007054 | Joy Wong | Behavioral Analyst | 18726 S Western Ave Ste 408, Gardena, CA 90248-3858 | 2011-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1154811297 | Patrick Lee | Technician/Technologist | 18203 S. Western Ave Ste. 102, Torrance, CA 90248 | 2018-05-15 |
| 1386152445 | Ariana Felicitas Nieves | Behavioral Analyst | 870 W 190th St Ste 400, Gardena, CA 90248 | 2018-01-11 |
| 1265949606 | Jessica Keller | Behavioral Analyst | 879 W 190th St Suite 400, Gardena, CA 90248 | 2018-01-08 |
| 1265941199 | Jaimee E Munson | Behavioral Analyst | 18726 S. Western Ave St, #408, Gardena, CA 90248 | 2017-09-22 |
| 1922467349 | Fred Jefferson Memorial Homes | Substance Abuse Rehabilitation Facility | 152 W. Walnut, Suite 150, Gardena, CA 90248 | 2016-02-12 |
| 1922427442 | Shana Reilly | Behavioral Analyst | 18726 S. Western Ave., Suite 408, Los Angeles, CA 90248 | 2014-04-11 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1093057598 | Aids Health Foundation | Pharmacist | 19300 S. Hamilton Ave., Ste 170, Gardena, CA 90248 | 2013-03-22 |
| 1245576594 | Hye Mi Kim | Behavioral Analyst | 18726 S. Western Ave.,#408, Gardena, CA 90248 | 2012-12-13 |
| Find all providers in zip 90248 | ||||
| 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 |
|---|---|---|---|---|
| 1750848040 | Mayra Saucedo | Behavior Technician | 1248 W 186th St, Gardena, CA 90248-4117 | 2019-02-22 |
| 1700356136 | Breauna Shanel Sharp | Behavior Technician | 1508 W Artesia Sq, Gardena, CA 90248-4766 | 2018-11-28 |
| 1295210474 | Arelis Becerra | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2018-10-03 |
| 1376143073 | Paulina Cervantes | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| 1053911701 | Kaylan De La Torre | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| 1558961243 | Vincent Barner | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| 1316547094 | Janette Madrid-franco | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| 1649870320 | Amber Bangma | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| 1235739988 | Katherine Bustamante | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| 1366042038 | Cattleya Cunvong | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2020-10-30 |
| Find all providers in GARDENA | ||||
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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.