MEDICARE: ABIGAIL CAESAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1598267742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL CAESAR

Provider Business Mailing Address
First Line	:	18726 S WESTERN AVE
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-3813
Country	:	US
Telephone Number	:	310-856-0800
Fax Number	:	855-568-2492

Provider Business Practice Location Address
First Line	:	2033 GATEWAY PL UNIT 614
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95110-3709
Country	:	US
Telephone Number	:	669-205-1778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2018
Last Update Date	:	06/03/2025

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Directions to “ ABIGAIL CAESAR ” Practice Location

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