Healthcare Provider Details

I. General information

NPI: 1972911295
Provider Name (Legal Business Name): YVONNE MCGAUGHEY PSYD, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 11/15/2020
Certification Date: 11/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44444 20TH ST W
LANCASTER CA
93534-2714
US

IV. Provider business mailing address

44444 20TH ST W
LANCASTER CA
93534-2714
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-2225
  • Fax: 661-726-2320
Mailing address:
  • Phone: 661-579-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-8657
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number31687
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: