Healthcare Provider Details

I. General information

NPI: 1497597033
Provider Name (Legal Business Name): KATHERINE ANNE CONRADO BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE 185
CONCORD CA
94520-5006
US

IV. Provider business mailing address

20780 4TH ST APT 7
SARATOGA CA
95070-5849
US

V. Phone/Fax

Practice location:
  • Phone: 650-417-5266
  • Fax:
Mailing address:
  • Phone: 650-417-5266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-69431
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: