Healthcare Provider Details

I. General information

NPI: 1336895754
Provider Name (Legal Business Name): OLIVIA PERCHE BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8760 CUYAMACA ST FL 2
SANTEE CA
92071-6210
US

IV. Provider business mailing address

8760 CUYAMACA ST FL 2
SANTEE CA
92071-6210
US

V. Phone/Fax

Practice location:
  • Phone: 931-449-3891
  • Fax: 833-515-2618
Mailing address:
  • Phone: 931-449-3891
  • Fax: 833-515-2618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16705
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: