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

Individual provider Behavior Analyst · NPI 1447856950

Kallie Provencher, BCBA is a Behavior Analyst in Stockton, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2020
What do these letters mean?
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

1811 Grand Canal Blvd Ste 2
Stockton, CA 95207-8107
Phone: (877) 418-2978
Fax: (866) 500-2186
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X (CA)

Record details

NPI number1447856950
Entity typeIndividual (Type 1)
GenderFemale
Credentials BCBA
Sole proprietorNo
NPI enumeratedDecember 9, 2020
Last updated in NPPESMarch 8, 2023
Certification dateMarch 8, 2023
Mailing address350 Fairway Dr Ste 101, Deerfield Beach, FL 33441-1834

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