KENNEDI BROUSSARD
NPI 1639835275
Behavior Technician in San Diego, CA

Active since November 09, 2021
3878 RUFFIN RD STE B, SAN DIEGO, CA 92123(619) 795-9925 Get Directions Write a Review

NPPES record last updated: November 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 15, 2021, Nov 9, 2021 (2 updates tracked since 2021).

About Kennedi Broussard NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDI BROUSSARD (NPI 1639835275) is an individual behavior technician in San Diego, California and active in the NPI registry since November 2021.

NPPES Registry Identity

NPI1639835275
Entity TypeIndividualFemale
Primary Taxonomy106S00000X
Provider Legal NameKENNEDI BROUSSARD
Location Address3878 RUFFIN RD STE BSan Diego, CA 92123-1842
Mailing Address8885 Rio San Diego Dr Ste 340San Diego, CA 92108-1669 · (619) 795-9925 · Fax (877) 602-5087
Sole ProprietorNo
Enumeration DateNovember 9, 2021
Last NPPES UpdateNovember 15, 20212 updates tracked since enumeration
NPPES CertifiedNovember 15, 2021
NPI 1639835275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyBehavior TechnicianBehavioral Health & Social Service Providers
Taxonomy Code106S00000X
Definition
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.
3878 RUFFIN RD STE B, San Diego, CA 92123

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Analyst
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123
Behavior Technician
3878 RUFFIN RD STE B
SAN DIEGO, CA 92123

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedi Broussard's NPI number?

The NPI number for Kennedi Broussard is 1639835275. It was assigned to this individual provider in the NPPES registry on November 9, 2021.

Where is Kennedi Broussard located?

Kennedi Broussard practices at 3878 Ruffin Rd Ste B, San Diego, CA 92123. The listed phone number is (619) 795-9925.

What is Kennedi Broussard's specialty?

The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.

When was this NPI record last updated?

The NPPES record for Kennedi Broussard was last updated on November 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.