Active NPI
Caetlen Mandeville, BCBA
- Behavior Analyst
- Waipahu, HI
National Provider Identifier
1407346737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA-802
- Practice address
- 94-849 Lumiaina St Unit 201
Waipahu, HI 96797-5677 - Phone
- (855) 223-7123
- NPI assigned
- May 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-51442 | CO | |
| Behavior Analyst | 103K00000X | BA-802 | HI | Primary |
Addresses
Primary practice location
94-849 Lumiaina St Unit 201
Waipahu, HI 96797-5677
Mailing address
PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123
Other practice location 1
1330 Quail Lake Loop Ste 120
Colorado Springs, CO 80906-4651
Phone (855) 223-7123
Other practice location 2
465 S Newport Way
Denver, CO 80224-1321
Phone (810) 304-6079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BA-802 | HI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1407346737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33568",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921633568",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-849 LUMIAINA ST UNIT 201",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967975677",
"telephone_number": "855-223-7123"
}
],
"practiceLocations": [
{
"address_1": "1330 Quail Lake Loop Ste 120",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809064651",
"country_code": "US",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "465 S Newport Way",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802241321",
"country_code": "US",
"telephone_number": "810-304-6079",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANDEVILLE",
"first_name": "CAETLEN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-11",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CO",
"license": "1-21-51442",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "HI",
"license": "BA-802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.