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KALLIE PROVENCHER BCBA
NPI 1447856950
Behavior Analyst in Stockton, CA

Active since December 09, 2020
1811 GRAND CANAL BLVD STE 2, STOCKTON, CA 95207(877) 418-2978(866) 500-2186 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 8, 2023, Dec 9, 2020 (2 updates tracked since 2020).

About Kallie Provencher Bcba NPPES

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

KALLIE PROVENCHER BCBA (NPI 1447856950) is an individual behavior analyst provider in Stockton, California and active in the NPI registry since December 2020. She maintains a secondary practice location in Concord.

NPPES Registry Identity

NPI1447856950
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameKALLIE PROVENCHERCredential: BCBA
Location Address1811 GRAND CANAL BLVD STE 2Stockton, CA 95207-8107
Mailing Address350 Fairway Dr Ste 101Deerfield Beach, FL 33441-1834
Phone(877) 418-2978
Fax(866) 500-2186
Sole ProprietorNo
Enumeration DateDecember 9, 2020
Last NPPES UpdateMarch 8, 20232 updates tracked since enumeration
NPPES CertifiedMarch 8, 2023
✔ NPI 1447856950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
Definition
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. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
1811 GRAND CANAL BLVD STE 2, Stockton, CA 95207
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Secondary Practice Location 1

Location 11200 Concord Ave Ste 100Concord, CA 94520-4969 · Phone (510) 934-3398

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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.

SHADEED HASAN II
Behavior Analyst
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (877) 418-2978
JAYNEE YANG
Behavior Technician
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (916) 683-1109
TIFFANY TOWLE
Behavior Technician
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (209) 942-1155
BRIANA GUZMAN
Behavior Technician
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (877) 418-2978
ELISE ROSE ESCOBAR
Behavior Analyst
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (877) 418-2978
SALLY SOROUR
Behavior Technician
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (888) 880-9270
HECTOR ARVIZU-MEDINA
Behavior Technician
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (209) 452-8996
ALYSSA MANDY ITURRIAGA
Behavior Technician
1811 GRAND CANAL BLVD STE 2
STOCKTON, CA 95207
San Joaquin County (209) 452-8996

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 Kallie Provencher's NPI number?

The NPI number for Kallie Provencher is 1447856950. It was assigned to this individual provider in the NPPES registry on December 9, 2020.

Where is Kallie Provencher located?

Kallie Provencher practices at 1811 Grand Canal Blvd Ste 2, Stockton, CA 95207. The listed phone number is (877) 418-2978.

What is Kallie Provencher's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

What insurance does Kallie Provencher accept?

Health plans from Providence Health Plan list Kallie Provencher as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kallie Provencher was last updated on March 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.