JENNIFER LYNE CARRILLO (NPI# 1700215217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700215217 |
| Entity Type | Individual |
| Full Name | JENNIFER LYNE CARRILLO |
| Credential | BCBA |
| Practice Address |
5762 Bolsa Ave Suite 101 Huntington Beach CA 92649-1172 |
| Mailing Address |
223 Marketview Irvine CA 92602-1689 |
| Practice Telephone | 7142922322 |
| Mailing Telephone | 7143158871 |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1-13-13534 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457583 | Jennifer Carrillo | Behavior Technician | 1682 Virginia Ave Apt 1, San Jose, CA 95116-2944 | 2020-11-04 |
| 1902284425 | Jennifer M Carrillo | Marriage & Family Therapist | 415 W Foothill Blvd Ste 232, Claremont, CA 91711-2779 | 2015-05-16 |
| 1053979542 | Jennifer M Carrillo | Student in an Organized Health Care Education/Training Program | 333 S Beaudry Ave, Los Angeles, CA 90017-1466 | 2019-05-30 |
| 1922348929 | Jennifer Marie Carrillo | Case Manager/Care Coordinator | 10428 Lower Azusa Rd, El Monte, CA 91731-1208 | 2013-02-27 |
| 1902186828 | Jennifer Lisseth Carrillo | Marriage & Family Therapist | 10929 South St, Suite 208b, Cerritos, CA 90703-5340 | 2011-08-23 |
| 1548223209 | Jennifer Carrillo | Specialist/Technologist | 1 University Dr, Athletic Department, Aliso Viejo, CA 92656-8081 | 2006-04-11 |
| Street Address |
5762 BOLSA AVE SUITE 101 |
| City | HUNTINGTON BEACH |
| State | CA |
| Zip Code | 92649-1172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184651887 | Caroljean Mclean | Nurse Practitioner | 5762 Bolsa Ave, Suite 107, Huntington Beach, CA 92649-1172 | 2006-06-27 |
| 1447721626 | Stephainine Cooper | Behavior Technician | 5762 Bolsa Ave, Huntington Beach, CA 92649-1172 | 2018-12-16 |
| 1508380361 | Karen Majdalani | Marriage & Family Therapist | 5762 Bolsa Ave, Huntington Beach, CA 92649-1172 | 2017-08-02 |
| 1720502198 | Abigail Q Ayala | Behavior Technician | 5762 Bolsa Ave, Huntington Beach, CA 92649-1172 | 2017-07-27 |
| 1871033597 | Jessica Wight | Behavior Technician | 5762 Bolsa Ave, Suite 101, Huntington Beach, CA 92649-1172 | 2017-02-28 |
| 1003353319 | Jacquelyn Vargas | Behavior Technician | 5762 Bolsa Ave, Suite 101, Huntington Beach, CA 92649-1172 | 2017-01-24 |
| 1801333273 | Cayla Patel | Behavior Technician | 5762 Bolsa Ave, Suite 101, Huntington Beach, CA 92649-1172 | 2017-01-24 |
| 1891231585 | Julia Morairty | Behavior Technician | 5762 Bolsa Ave, Suite 101, Huntington Beach, CA 92649-1172 | 2017-01-18 |
| 1326584293 | Elaine Nguyen | Behavior Technician | 5762 Bolsa Ave, Suite 101, Huntington Beach, CA 92649-1172 | 2017-01-16 |
| 1477099331 | Jan Pesigan | Behavior Technician | 5762 Bolsa Ave, Suite 101, Huntington Beach, CA 92649-1172 | 2017-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639305 | Tanisha Grant | Behavioral Analyst | 4592 Warner Ave, Huntington Beach, CA 92649 | 2020-11-04 |
| 1023582772 | Stanley Wayne Combs | Emergency Medicine | 16761 Edgewater Lane, Huntington Beach, CA 92649 | 2019-01-16 |
| 1609382084 | Loc Do | Pharmacist | 16922 Bolsa Chica, Huntington Beach, CA 92649 | 2017-12-20 |
| 1487166765 | Holly Forman | Marriage & Family Therapist | 17121 Tiffany Circle, Huntington Beach, CA 92649 | 2017-10-26 |
| 1205362522 | Pmh Laboratory Inc | Clinical Medical Laboratory | 5862 Edinger Ave, Huntington Beach, CA 92649 | 2017-05-05 |
| 1972050086 | Clear Reflections Psychol Assocs | Social Worker | 16897 Algonquin St., Ste L, Huntington Beach, CA 92649 | 2016-09-07 |
| 1588011274 | Wisdom Foods Inc | Dietitian, Registered | 16987 Algonquin Street Suite L, Huntington Beach, CA 92649 | 2016-05-23 |
| 1801253398 | Thierry Kolpin | Psychologist | 5202 Edinger, Huntington Beach, CA 92649 | 2016-01-28 |
| 1811374242 | Margarita Bernardo Velarde | Pediatrics | 17392 Wildrose Lane, Huntington Beach, CA 92649 | 2015-05-06 |
| 1023439809 | Orange County Labs Inc. | Clinical Medical Laboratory | 15165 Triton Ln, Huntington Beach, CA 92649 | 2013-12-23 |
| Find all providers in zip 92649 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639305 | Tanisha Grant | Behavioral Analyst | 4592 Warner Ave, Huntington Beach, CA 92649 | 2020-11-04 |
| 1639723216 | Joanna Leal Inc | Behavioral Analyst | 17101 Herbert Ln, Huntington Beach, CA 92649-4523 | 2019-07-31 |
| 1144729328 | Benjamin Andrew Smith | Behavioral Analyst | 7755 Center Ave Ste 1100, Huntington Beach, CA 92647-3091 | 2018-02-02 |
| 1306389440 | Nhi Pham Nguyen | Behavioral Analyst | 17732 Beach Blvd., Suite G, Huntington Beach, CA 92647 | 2016-11-21 |
| 1902353022 | Advances In Behavior Analysis, Inc | Behavioral Analyst | 18672 Florida Street, Suite 100, Huntington Beach, CA 92648-1925 | 2016-09-07 |
| 1962859298 | Joanna Leal | Behavioral Analyst | 16792 Talisman Ln Apt 205, Huntington Beach, CA 92649-3118 | 2016-05-17 |
| 1962820357 | Tiffany Nicole Mendez | Behavioral Analyst | 4952 Warner Ave Ste 300, Huntington Beach, CA 92649-5506 | 2014-04-02 |
| 1245661727 | Amanda Grace Dissmore | Behavioral Analyst | 8112 Pawtucket Dr, Huntington Beach, CA 92646-6734 | 2013-12-09 |
| 1184065948 | Megan Price | Behavioral Analyst | 8902 Albatross, Huntington Beach, CA 92646 | 2013-07-09 |
| 1922345339 | Destini Kulik | Behavioral Analyst | 5762 Bolsa Ave Ste 100, Huntington Beach, CA 92649-1172 | 2013-01-07 |
| Find all providers in HUNTINGTON BEACH | ||||
| City | HUNTINGTON BEACH |
| Zip Code | 92649 |
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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.