Provider Demographics
NPI:1700584430
Name:CALL, EMBER DAWN
Entity Type:Individual
Prefix:
First Name:EMBER
Middle Name:DAWN
Last Name:CALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAKE
Other - Middle Name:DAWN
Other - Last Name:CALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5850 GRANITE PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6753
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:732 CARNEGIE DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3589
Practice Address - Country:US
Practice Address - Phone:909-756-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician