MICHELLE DYSLIN (NPI# 1952919359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952919359 |
| Entity Type | Individual |
| Full Name | MICHELLE DYSLIN |
| Practice Address |
4030 Moorpark Ave Ste 105 San Jose CA 95117-1848 |
| Mailing Address |
18726 S Western Ave Ste 408 Gardena CA 90248-3858 |
| Practice Telephone | 6694445980 |
| Practice Fax Number | 8555682494 |
| Mailing Telephone | 3108560800 |
| Mailing Fax Number | 8555682494 |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |
| 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 |
4030 MOORPARK AVE STE 105 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95117-1848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578074852 | Gwen Stephens | Behavioral Analyst | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2017-10-13 |
| 1356958342 | Taylor Slaughterbeck | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-09-24 |
| 1235746215 | Oanh Nguyen | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-09-24 |
| 1780291765 | Adriana Mendez | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-09-24 |
| 1730796731 | Ha Young So | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-09-24 |
| 1881202224 | Jamie Han | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-07-22 |
| 1982212338 | Lilian Anh | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-07-21 |
| 1689299950 | Victoria Lieb | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-06-12 |
| 1063041598 | Mai Tran | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-04-06 |
| 1255960779 | Raymond Pizano | Behavior Technician | 4030 Moorpark Ave Ste 105, San Jose, CA 95117-1848 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154978385 | Rebecca Giordano St George | Marriage & Family Therapist | 390 Spar Avenue Suite 106, San Jose, CA 95117 | 2019-08-22 |
| 1760035067 | Na Bao Inc | Acupuncturist | 631 Rebecca Way, Apt D, San Jose, CA 95117 | 2019-07-17 |
| 1801364823 | Acupuncture & Healing Inc | Acupuncturist | 4155 Moorpark Ave Ste #13, San Jose, CA 95117 | 2018-11-07 |
| 1689199770 | Youngsu Lyu | Chiropractor | 4010 Moorpark Ave Ste 109, San Jose, CA 95117 | 2017-08-09 |
| 1790139137 | January Villarreal | Speech-Language Pathologist | 4010 Moorpark Ave. #117, San Jose, CA 95117 | 2016-04-22 |
| 1780069187 | Il Hwan Park Chiropractic Clinic | Chiropractor | 4155 Moorpark Avenue, Suite 1, San Jose, CA 95117 | 2015-07-27 |
| 1285077073 | John Lockhart Mcelroy | Family Medicine | 3578 Moultrie Ave., San Diego, CA 95117 | 2013-04-10 |
| 1801134036 | Min Jung Kang | Acupuncturist | 4155 Moorpark Ave Ste 20, San Jose, CA 95117 | 2013-01-23 |
| 1356574420 | Scott Svendsen | Chiropractor | 3531 Stevens Creek Blvd., San Jose, CA 95117 | 2009-08-24 |
| 1316191893 | Christopher Corsa | Dentist | 4010 Moorpark Ave Ste 105, San Jose, CA 95117 | 2008-11-10 |
| Find all providers in zip 95117 | ||||
| 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 |
|---|---|---|---|---|
| 1407457583 | Jennifer Carrillo | Behavior Technician | 1682 Virginia Ave Apt 1, San Jose, CA 95116-2944 | 2020-11-04 |
| 1720689268 | Elizabeth Bigelow | Behavior Technician | 5751 Via Monte Dr Apt B, San Jose, CA 95118-3271 | 2020-11-02 |
| 1720685357 | Natia Chitadze | Behavior Technician | 5875 Charlotte Dr Apt 307, San Jose, CA 95123-6871 | 2020-10-06 |
| 1235746306 | Patricia Yazmin Landa Garibay | Behavior Technician | 820 N Jackson Ave, San Jose, CA 95133-1223 | 2020-09-23 |
| 1134739022 | Esperanza Garnica | Behavior Technician | 346 Menker Ave, San Jose, CA 95128-2401 | 2020-08-05 |
| 1629688593 | Jael Nunez Saavedra | Behavior Technician | 1497 Saratoga Ave, San Jose, CA 95129-4938 | 2020-08-05 |
| 1194334839 | Jason Sanders Jr. | Behavior Technician | 1590 De Rose Way, San Jose, CA 95126-4141 | 2020-07-29 |
| 1134738875 | Ugochukwu Kas-osoka | Behavior Technician | 164 Park Sharon Dr, San Jose, CA 95136-2535 | 2020-07-29 |
| 1104443407 | Khady Fall | Behavior Technician | 408 494 1561, 614 Tully Road, San Jose, CA 95112 | 2020-07-02 |
| 1114544376 | Katrina Chua | Behavior Technician | 369 Longhill Ct, San Jose, CA 95138-1392 | 2020-07-02 |
| Find all providers in SAN JOSE | ||||
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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.