MR. BENJAMIN EVAN FICOCIELLO (NPI# 1104227818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104227818 |
| Entity Type | Individual |
| Full Name | MR. BENJAMIN EVAN FICOCIELLO |
| Practice Address |
1101 S Winchester Blvd Ste B110 San Jose CA 95128 |
| Mailing Address |
1101 S Winchester Blvd Ste B110 San Jose CA 95128-3914 |
| Practice Telephone | 4084841028 |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2018-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
MA | Behavioral Health & Social Service Providers | |
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BMC | 0000023532 | 01 |
| MA | NHP | 1004745 | 01 |
| MA | TAX ID | 042611055 | 01 |
| MA | NETWORK HEALTH | 99618201 | 01 |
| MA | 1303287 | 05 | |
| MA | BCBS | M18633 | 01 |
| MA | MBHP | 1303287 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1040 Waltham St, Lexington, MA 024218033 | 7818623600 |
| Street Address |
1101 S WINCHESTER BLVD STE B110 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619583002 | Jasmine Alvarez-jimenez | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-09-21 |
| 1831705284 | Sofia Brewington-williams | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-09-21 |
| 1073129474 | Kevin Origel | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-09-21 |
| 1104432533 | Amanda Dunning | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-09-21 |
| 1437763141 | Sarah Chue | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-09-01 |
| 1942812532 | Amanda Baker | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-08-17 |
| 1952913576 | Jennifer Chang | Speech-Language Pathologist | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-08-17 |
| 1952919995 | Kim Ngan Hoang | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-07-15 |
| 1235764929 | Joseline Perez | Behavior Technician | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-03-03 |
| 1114567179 | Julie Wallingford | Behavioral Analyst | 1101 S Winchester Blvd Ste B110, San Jose, CA 95128-3914 | 2020-01-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| 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 |
|---|---|---|---|---|
| 1194332049 | B Is for Butterfly | Behavioral Analyst | 1314 Bilbo Ct, San Jose, CA 95121-2402 | 2020-09-24 |
| 1942816673 | Christian Jose Antonio Carrillo | Behavioral Analyst | 2420 Klein Rd, San Jose, CA 95148-1801 | 2020-09-17 |
| 1770193146 | Melissa Leon Sierra | Behavioral Analyst | 2146 Pacina Dr, San Jose, CA 95116-3647 | 2020-07-31 |
| 1215552435 | Jaime Kim | Behavioral Analyst | 1494 Hamilton Ave, San Jose, CA 95125-4535 | 2020-06-12 |
| 1346865979 | Bloom Aba | Behavioral Analyst | 2326 Oak Flat Rd, San Jose, CA 95131-1929 | 2020-06-09 |
| 1760018907 | Vanessa Parker | Behavioral Analyst | 2895 Old Almaden Rd Apt 12, San Jose, CA 95125-4236 | 2020-03-19 |
| 1326673104 | Roque Leon | Behavioral Analyst | 576 S 5th St Apt 18, San Jose, CA 95112-5649 | 2020-03-11 |
| 1881234482 | Silvia Maria Pinto | Behavioral Analyst | 2007 W Hedding St Ste 214, San Jose, CA 95128-1428 | 2020-01-10 |
| 1376182717 | Serena Richardson | Behavioral Analyst | 2007 W Hedding St Ste 201, San Jose, CA 95128-1428 | 2020-01-02 |
| 1205479409 | Jennifer Hunter | Behavioral Analyst | 223 Birch Ridge Cir, San Jose, CA 95123-2655 | 2019-10-21 |
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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.