Provider Demographics
NPI:1376263145
Name:CAYA, KENDALL DIANNE (RBT)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:DIANNE
Last Name:CAYA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GROGANS MILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-2416
Mailing Address - Country:US
Mailing Address - Phone:210-394-2353
Mailing Address - Fax:
Practice Address - Street 1:1020 CENTRAL PKWY S
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-5021
Practice Address - Country:US
Practice Address - Phone:210-798-2273
Practice Address - Fax:210-495-1479
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-09-16
Deactivation Date:2022-08-31
Deactivation Code:
Reactivation Date:2022-09-16
Provider Licenses
StateLicense IDTaxonomies
TXRBT-22-232765106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician