Individual provider · Type 1 NPI

Kallie Provencher, BCBA

Behavior Analyst · Stockton, CA

NPI number 1447856950 Active

Practice location

1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107

Call (877) 418-2978 Map

Fax (866) 500-2186

Mailing address

350 Fairway Dr Ste 101
Deerfield Beach, FL 33441-1834

Other practice locations

  • 1200 Concord Ave Ste 100, Concord, CA 94520-4969 · (510) 934-3398

Specialties and licenses

TaxonomyCodeLicense
Behavior Analyst Primary 103K00000XNone listed

Behavior 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…

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About NPI 1447856950

Kallie Provencher, BCBA's National Provider Identifier is 1447856950, issued on Dec 9, 2020. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in Stockton, CA. The record was last updated on Mar 8, 2023.