Provider Demographics
NPI:1083141956
Name:GUMAER, CAITLYN BAILEY (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:BAILEY
Last Name:GUMAER
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2093
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92654-2093
Mailing Address - Country:US
Mailing Address - Phone:562-307-0520
Mailing Address - Fax:
Practice Address - Street 1:3685 KEARNY VILLA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1950
Practice Address - Country:US
Practice Address - Phone:858-966-7453
Practice Address - Fax:858-966-8011
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94027285103T00000X, 172V00000X
CA1-15-17924103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No172V00000XOther Service ProvidersCommunity Health Worker