Provider Demographics
NPI:1649527565
Name:MCCABE, JONATHAN (BCBA)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:MCCABE
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 1:31561 CALLE DE LAS ESTRELLAS
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-3721
Mailing Address - Country:US
Mailing Address - Phone:530-717-3200
Mailing Address - Fax:530-717-3200
Practice Address - Street 1:31561 CALLE DE LAS ESTRELLAS
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-3721
Practice Address - Country:US
Practice Address - Phone:530-717-3200
Practice Address - Fax:530-717-3200
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-7196103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst