JEFFREY GLEN KELLY SR. (NPI# 1508338294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508338294 |
| Entity Type | Individual |
| Full Name | JEFFREY GLEN KELLY SR. |
| Practice Address |
4540 Harlin Dr Sacramento CA 95826-9716 |
| Practice Telephone | 9163647800 |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255750840 | Jeffrey Kelly | Specialist/Technologist | 7220 N Lindbergh, Salyer Perfusion Blvd Ste 360, St. Louis, MO 63042 | 2014-04-10 |
| 1194898544 | Jeffrey Kelly | Physician Assistant | 1800 Mulberry St, Scranton, PA 18510-2369 | 2006-11-15 |
| 1932159928 | Jeffrey Alan Kelly | Chiropractor | 4266 State St, Saginaw, MI 48603-4028 | 2006-05-11 |
| 1477538353 | Jeffrey Scott Kelly | Anesthesiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-13 |
| 1770565384 | Jeffrey John Kelly | Dermatology | 3643 W Front St, Suite A, Traverse City, MI 49684-7759 | 2005-11-18 |
| Street Address |
4540 HARLIN DR |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95826-9716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942519715 | Applied Behavior Consultants, Inc. | Community/Behavioral Health | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2010-09-28 |
| 1265033278 | Anyla Simon | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-11-05 |
| 1528669538 | Marcela Ohlgart | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-11-05 |
| 1689280794 | Maylan O Hill | Assistant Behavior Analyst | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-09-23 |
| 1205447950 | Maria Yesenia Trinidad | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-08-14 |
| 1558999565 | Regina Schneider | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-03-27 |
| 1366076390 | Courtney Elizabeth Bollinger | Assistant Behavior Analyst | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-02-28 |
| 1770117228 | Kevin Anthony Puppo | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-02-24 |
| 1811520448 | Monica Perez | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-02-21 |
| 1003446568 | Ashley Rose West | Behavior Technician | 4540 Harlin Dr, Sacramento, CA 95826-9716 | 2020-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326688094 | Brooke Oliver | Behavior Technician | Sacramento 8801 Folsom Blvd., Ste. 195, Sacramento, CA 95826 | 2020-01-10 |
| 1679126908 | Albert Einstein Middle School /sacramento City Unified School District | Local Education Agency (LEA) | 9325 Mirandy Drive, Albert Einstein Middle School, Sacramento, CA 95826 | 2019-07-16 |
| 1487146833 | Sarah Collins | Counselor | 4212 Westporter Dr, Sacramento, CA 95826 | 2018-06-01 |
| 1831609221 | Stacey Ann Moote | Behavior Technician | 8795 La Riviera Dr 169, 169, Sacramento, CA 95826 | 2017-10-11 |
| 1033649041 | Joseph Stephen Rapozo | Counselor | 3600 Power Inn Road, Sacramento, CA 95826 | 2017-06-13 |
| 1497201289 | Maureen Belli-bomgardner | Counselor | 3201 Florin Perkins Road, Sacramento, CA 95826 | 2016-08-31 |
| 1316317613 | Tlcs, Inc. | Community/Behavioral Health | 9342 Tech Center Drive, Ste.600, Sacramento, CA 95826 | 2015-09-29 |
| 1942683479 | Tlcs, Inc. | Community/Behavioral Health | 9333 Tech Center Drive, Ste. 100, Sacramento, CA 95826 | 2015-07-01 |
| 1881071157 | Rene Frentzen | Case Manager/Care Coordinator | 9394 Tech Center Drive, Suite 200, Sacramento, CA 95826 | 2015-05-06 |
| 1184026262 | Bojana Pandurevic | Marriage & Family Therapist | 9343 Tech Center Drive, Suite 200, Sacramento, CA 95826 | 2014-09-21 |
| Find all providers in zip 95826 | ||||
| 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 |
|---|---|---|---|---|
| 1801497821 | Daisia Newman | Behavior Technician | 3038 Great Egret Way, Sacramento, CA 95834-1096 | 2020-11-05 |
| 1366041105 | Brooke Doutherd | Behavior Technician | 204 Selby Ranch Rd Apt 7, Sacramento, CA 95864-5812 | 2020-10-22 |
| 1740889633 | Catherine Andrade | Behavior Technician | 7958 Pocket Rd Apt 67, Sacramento, CA 95831-5713 | 2020-10-21 |
| 1962009308 | Andrea Isabel Morales | Behavior Technician | 333 University Avenue, Suite 200, Sacramento, CA 95825 | 2020-10-08 |
| 1609473156 | Joshua A Soto | Behavior Technician | 1300 Ethan Way Ste 100, Sacramento, CA 95825-2295 | 2020-10-07 |
| 1184231714 | Nancy Vue | Behavior Technician | 276 Olmstead Dr, Sacramento, CA 95838-4742 | 2020-09-28 |
| 1609482090 | Javonte Wills | Behavior Technician | 511 9th St Apt 2, Sacramento, CA 95814-1340 | 2020-09-21 |
| 1861006850 | Ayanna Enzy Johnson | Behavior Technician | 1400 Brewerton Dr, Sacramento, CA 95833-1981 | 2020-09-07 |
| 1740894138 | Esmeralda Rodriguez | Behavior Technician | 725 Howe Ave Apt 66, Sacramento, CA 95825-4612 | 2020-09-02 |
| 1881207413 | Angela Santana | Behavior Technician | 1451 River Park Dr Ste 400, Sacramento, CA 95815-4507 | 2020-08-24 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95826 |
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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.