Provider Demographics
NPI:1992067490
Name:CATON, DAJUAN L
Entity type:Individual
Prefix:
First Name:DAJUAN
Middle Name:L
Last Name:CATON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6145 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3030
Mailing Address - Country:US
Mailing Address - Phone:702-641-1936
Mailing Address - Fax:702-641-1940
Practice Address - Street 1:6145 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3030
Practice Address - Country:US
Practice Address - Phone:702-641-1936
Practice Address - Fax:702-641-1940
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1603544529Medicaid