Search › California › 103K00000X
Kallie Provencher, BCBA
NPI 1447856950 · on the registry since 2020
Practice
- Address
- 1811 Grand Canal Blvd Ste 2
Stockton, CA 95207 - Phone
- (877) 418-2978
- Fax
- (866) 500-2186
- Organisation at this address
- Butterfly Effects
Butterfly Effects
Mind Body Medicine IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 1,400
Additional practice sites
- 1200 Concord Ave Ste 100, Concord, CA
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-03-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California