Healthcare Provider Details

I. General information

NPI: 1407750524
Provider Name (Legal Business Name): CADEY MULLIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34448 YUCAIPA BLVD STE A
YUCAIPA CA
92399-2412
US

IV. Provider business mailing address

2824 SUNDANCE CIR W
PALM SPRINGS CA
92262
US

V. Phone/Fax

Practice location:
  • Phone: 909-353-7547
  • Fax:
Mailing address:
  • Phone: 619-922-5674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: