Healthcare Provider Details

I. General information

NPI: 1255929352
Provider Name (Legal Business Name): DAVID KELTON BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 LA SIESTA WAY APT 302
NATIONAL CITY CA
91950-5390
US

IV. Provider business mailing address

8735 DUNWOODY PL STE N
SANDY SPRINGS GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 209-806-9863
  • Fax:
Mailing address:
  • Phone: 209-806-9863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-67799
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-67799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: