MAXWELL KHANIN (NPI# 1649823923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649823923 |
| Entity Type | Individual |
| Full Name | MAXWELL KHANIN |
| Practice Address |
1001 Sneath Ln San Bruno CA 94066-2308 |
| Mailing Address |
412 Paramount Dr Millbrae CA 94030-1327 |
| Practice Telephone | 6502439849 |
| Mailing Telephone | 4153851527 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | 72530271 | 01 |
| Street Address |
1001 SNEATH LN |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710082201 | Kathleen Yvonne Bennett | Social Worker | 1001 Sneath Ln, Suite 300, San Bruno, CA 94066-2308 | 2006-09-13 |
| 1033732573 | Jenny Estrada | Counselor | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2020-05-19 |
| 1144870577 | Matthew Oliver Dimabuyu | Behavior Technician | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-09-17 |
| 1326690462 | Jada Faye Chappel | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-07-09 |
| 1164085304 | Raymond J Taboada Jr. | Counselor | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-04-14 |
| 1962966390 | Mary Frances Granados | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-01-30 |
| 1902379878 | Dan Navarro | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-01-03 |
| 1689144024 | Kacey Lauren Lilly | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2018-11-28 |
| 1730658675 | Melissa Alvarez | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2018-11-21 |
| 1528533270 | Luis Isaac Chavez | Assistant Behavior Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2018-10-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| 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 |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1831752930 | Nicholas Eugene Putkey | Behavior Technician | 1940 Willow Way, San Bruno, CA 94066-1822 | 2019-04-16 |
| 1851852313 | Julia Rae Garcia | Behavior Technician | 1001 Sneath Ln Ste 20, San Bruno, CA 94066-2308 | 2019-03-27 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1548738669 | Pramila Kumar | Behavior Technician | 751 Camino Plz Ste 8, San Bruno, CA 94066-3401 | 2018-11-06 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1245729896 | Katrina Marie Pico-villaluna | Behavior Technician | 868 7th Ave, San Bruno, CA 94066-3227 | 2018-05-08 |
| 1144726001 | Diana Willits Evans | Behavior Technician | 751 Camino Plz # A, San Bruno, CA 94066-3401 | 2018-03-31 |
| Find all providers in SAN BRUNO | ||||
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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.