Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Ellis Petronella Van Den Boogaard, MSED, MA

Individual provider Behavior Technician · NPI 1891514824

Mrs. Ellis Petronella Van Den Boogaard, MSED, MA is a Behavior Technician in San Diego, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

5335 Calle Vis
San Diego, CA 92109-1920
Phone: (858) 882-7860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence 23-294299 (CA)
Behavior Technician Taxonomy 106S00000X · Licence 19-109521 (CA)

Record details

NPI number1891514824
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSED , MA
Sole proprietorNo
NPI enumeratedOctober 7, 2024
Last updated in NPPESOctober 7, 2024
Certification dateSeptember 30, 2024

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