Provider Demographics
NPI:1184342396
Name:STADLER, KAYA R (MS, BCBA)
Entity type:Individual
Prefix:
First Name:KAYA
Middle Name:R
Last Name:STADLER
Suffix:
Gender:
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4978 NIAGARA AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3187
Mailing Address - Country:US
Mailing Address - Phone:760-288-1808
Mailing Address - Fax:
Practice Address - Street 1:2404 F ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-2025
Practice Address - Country:US
Practice Address - Phone:619-493-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA1-25-80648103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst