Provider Demographics
NPI:1396133005
Name:CALDWELL, NACHOLE (BCBA)
Entity type:Individual
Prefix:
First Name:NACHOLE
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42456 WHITTIER AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-6537
Mailing Address - Country:US
Mailing Address - Phone:951-550-7293
Mailing Address - Fax:
Practice Address - Street 1:1700 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4679
Practice Address - Country:US
Practice Address - Phone:951-357-6959
Practice Address - Fax:951-356-2115
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-03
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1149427103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst