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General NPI Number Information
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NPI Number | 1760331144
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Entity Type | Organization
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Legal Business Name | CLEARWATER WELLNESS AND DEVELOPMENT LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 31561 CALLE DE LAS ESTRELLAS
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City | BONSALL
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State | CA
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Zip | 92003-3721
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Country | US
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Telephone | 530-717-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 31561 CALLE DE LAS ESTRELLAS
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City | BONSALL
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State | CA
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Zip | 92003-3721
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Country | US
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Telephone | 530-717-3200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JONATHAN MCCABE
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Credential | BCBA
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Telephone | 530-717-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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