Provider Demographics
NPI:1922687987
Name:DONDERO, JOSEPH EDWARD DONALD (BCBA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:EDWARD DONALD
Last Name:DONDERO
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 ROYAL HUNT CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1348
Mailing Address - Country:US
Mailing Address - Phone:562-760-9194
Mailing Address - Fax:
Practice Address - Street 1:598 E CHATHAM ST STE 135C
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6956
Practice Address - Country:US
Practice Address - Phone:910-631-7013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA1-21-53099103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician