KENDRA CHANTAL PARK (NPI# 1235746884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235746884 |
| Entity Type | Individual |
| Full Name | KENDRA CHANTAL PARK |
| Practice Address |
5305 Spine Rd Ste A Boulder CO 80301-3331 |
| Mailing Address |
21600 Oxnard St Ste 1800 Woodland Hills CA 91367-7807 |
| Practice Telephone | 7206432350 |
| Mailing Telephone | 8183452345 |
| Mailing Fax Number | 0000000000 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |
| 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 |
5305 SPINE RD STE A |
| City | BOULDER |
| State | CO |
| Zip Code | 80301-3331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588120307 | Devin Elizabeth Peterson | Behavioral Analyst | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2019-02-17 |
| 1174124689 | Center for Autism and Related Disorders LLC | Behavioral Analyst | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-11-03 |
| 1154929156 | Marie Ann Ross | Behavioral Analyst | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-10-12 |
| 1720685035 | Andre Tif Johnson II | Behavioral Analyst | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-10-08 |
| 1396351334 | Brook Christine Cunningham | Behavior Technician | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-09-16 |
| 1649896242 | Brooke Shewmaker | Behavior Technician | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-06-19 |
| 1881220499 | Marina Frances Efstathiu | Behavior Technician | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-03-14 |
| 1346873536 | Alexandra Anderson | Behavior Technician | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-02-17 |
| 1295367415 | Kendra Meyers | Behavior Technician | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2020-02-05 |
| 1285270231 | Sydni Erin Rapson | Behavioral Analyst | 5305 Spine Rd Ste A, Boulder, CO 80301-3331 | 2019-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031454 | Jonathan William Garson | Social Worker | 1790 30th St., Boulder, CO 80301 | 2020-10-20 |
| 1164048161 | Crossroads Medical Center | Family Medicine | 2760 29th St., Suite 28, Boulder, CO 80301 | 2020-06-25 |
| 1316585045 | Karissa Marlene Smith | Registered Nurse | 4770 Pearl Street, Suite A, Boulder, CO 80301 | 2019-12-12 |
| 1184273864 | National Doula Network | Doula | 5918 Gunbarrel Ave Apt E, Boulder, CO 80301 | 2019-09-05 |
| 1861047086 | Samuel Shay | Chiropractor | 1750 30th St, Ste 1, #226, Boulder, CO 80301 | 2019-08-05 |
| 1124504808 | Be Free Live Now LLC | Social Worker | 2945 Center Creen Court, Suite G211, Boulder, CO 80301 | 2018-07-16 |
| 1720596703 | Janis Dochterman | Counselor | 5378 Sterling Drive, Studio #3, Boulder, CO 80301 | 2018-01-12 |
| 1033628631 | Whitney Shea | Physical Therapy Assistant | 3020 Carbon Place, #330, Physical Therapy of Boulder, Boulder, CO 80301 | 2017-09-26 |
| 1538688908 | Kyle N. Daniel Dds PC | Dentist | 2830 Valmont Rd, Boulder, CO 80301 | 2017-09-16 |
| 1497205231 | Jenna Orosco | Counselor | 2945 Center Green Ct. Suite H, Suite H, Boulder, CO 80301 | 2016-10-05 |
| Find all providers in zip 80301 | ||||
| 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 |
|---|---|---|---|---|
| 1063010700 | Alyssa Ponsolle | Behavior Technician | 2305 Broadway St Fl 300010, Boulder, CO 80304-4106 | 2020-10-14 |
| 1538625298 | Anuja Anna Varghese | Behavior Technician | 860 W Moorhead Cir Apt 2i, Boulder, CO 80305-6131 | 2019-02-18 |
| 1235626151 | Chelsea Stallan | Behavior Technician | 4730 Table Mesa Dr # H200, Boulder, CO 80305-5560 | 2018-04-16 |
| 1215431630 | Mira Vk Patel | Behavior Technician | 4730 Table Mesa Dr Ste H-200, Boulder, CO 80305-5560 | 2018-03-20 |
| 1699283986 | Matthew Emrikson | Behavior Technician | 4730 Table Mesa Dr Ste H200, Boulder, CO 80305-5560 | 2018-01-20 |
| 1679089791 | Tiara Sutton | Behavior Technician | 2244 Goss Cir E Apt 1, Boulder, CO 80302-6635 | 2017-12-27 |
| 1225638927 | Alyssa Arden Reed | Behavior Technician | 2500 Arapahoe Ave Ste 230, Boulder, CO 80302-6752 | 2020-10-30 |
| 1417557315 | Danya Jade Demayo-lockhart | Behavior Technician | 2500 Arapahoe Ave Ste 230, Boulder, CO 80302-6752 | 2020-10-29 |
| 1710587985 | Caitlyn Fitzgerald | Behavior Technician | 2500 Arapahoe Ave Ste 230, Boulder, CO 80302-6752 | 2020-10-27 |
| 1346849874 | Olivia Soukup | Behavior Technician | 2500 Arapahoe Ave Ste 230, Boulder, CO 80302-6752 | 2020-10-26 |
| Find all providers in BOULDER | ||||
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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.