Caitlin Nicole Pena, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

109854 Issued in IA

Practice address

4959 Utica Ridge Rd
Davenport, IA 52807-3063

Phone

(641) 425-1702

NPI assigned

Jan 18, 2022

Last updated

Oct 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1720730054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 N CLARK ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042616",
            "telephone_number": "641-425-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 UTICA RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073063",
            "telephone_number": "641-425-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "CAITLIN",
        "middle_name": "NICOLE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IA",
            "license": "109854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearson Mental Health Therapy
• Colleen Pearson, RN
• Danielle Pearson, DC
• Retta E Pelsang, MD
• Shelby Marie Pelzer, ARNP
• Ashok R Penmatcha, M.D.
• Olivia Kaitlyn Penniston
• Suzanne M Peppers, PA
• Performance Psychiatric Consults LLC
• Charlene Marie Perkins, RN,LCCE,CD(DONA)

• Behavior Analyst in Davenport, IA
• Providers in Davenport, IA by specialty
• Behavior Analyst in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.