BROOKE BACON (NPI# 1932723343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932723343 |
| Entity Type | Individual |
| Full Name | BROOKE BACON |
| Practice Address |
1007 Calle Sombra Ste A San Clemente CA 92673-6244 |
| Practice Telephone | 9492726146 |
| Mailing Telephone | 9492726146 |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
1007 CALLE SOMBRA STE A |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-6244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982254140 | Isabella M De La Fuente | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2019-09-18 |
| 1588280994 | Raeanna Vanderelst | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-06-22 |
| 1558985960 | Nicole Rauterkus | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-06-01 |
| 1922622331 | Joel Mallams | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-06-01 |
| 1568086973 | Sara Rodriguez | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-06-01 |
| 1841821428 | Richard Medina | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-01-31 |
| 1497386700 | Bruna Falci Arana | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-01-27 |
| 1144868704 | Mckenna Jarrell | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2019-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| 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 |
|---|---|---|---|---|
| 1841832540 | Kelsey Lynn Laser | Behavior Technician | 123 Calle Amistad Unit 7205, San Clemente, CA 92673-6971 | 2019-10-14 |
| 1982254140 | Isabella M De La Fuente | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2019-09-18 |
| 1700436383 | Melanie Moore | Behavior Technician | 691 Via Barracuda, San Clemente, CA 92673-3607 | 2019-09-16 |
| 1942869565 | Brittany Gifford | Behavior Technician | 198 Cardinal Way, San Clemente, CA 92672-2615 | 2019-06-07 |
| 1962017590 | Shanelle Cabral | Behavior Technician | 1007 Calle Sombra, San Clemente, CA 92673-6244 | 2020-09-10 |
| 1063027688 | Shawn Smith | Behavior Technician | 1007 Calle Sombra, San Clemente, CA 92673-6244 | 2020-09-10 |
| 1164035994 | Catrina Ramirez | Behavior Technician | 1007 Calle Sombra, San Clemente, CA 92673-6244 | 2020-08-31 |
| 1275146003 | Marissa Calise | Behavior Technician | 1007 Calle Sombra, San Clemente, CA 92673-6244 | 2020-08-31 |
| 1629681457 | Anna Kreutinger | Behavior Technician | 1007 Calle Sombra, San Clemente, CA 92673-6244 | 2020-08-31 |
| 1588280994 | Raeanna Vanderelst | Behavior Technician | 1007 Calle Sombra Ste A, San Clemente, CA 92673-6244 | 2020-06-22 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
Please comment or provide details below to improve the information on BROOKE BACON.
| 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.