Jordan Grace Alley

Individual provider Active NPI Behavior Analyst · Santa Clara, CA

NPI 1104317023 · NPPES record last updated May 26, 2018

Key facts

NPI
1104317023
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
1171 Homestead Rd
#250
Santa Clara, CA 95050-5485
Phone
(510) 268-8120
NPI assigned
May 26, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

1171 Homestead Rd
#250
Santa Clara, CA 95050-5485

Mailing address

350 Budd Ave Apt H1
Campbell, CA 95008-4013
Phone (408) 455-1097

Other providers in Santa Clara, CA

All providers in Santa Clara, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.