Individual provider Active NPI

Jessica Duncan, BCBA

  • Behavior Analyst
  • Manteca, CA
National Provider Identifier
1396202164
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-55421 Issued in CA
Practice address
1083 Foxfire Dr
Manteca, CA 95337-6695
Phone
(916) 765-0456
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 1-21-55421 CA Primary

Addresses

Primary practice location

1083 Foxfire Dr
Manteca, CA 95337-6695

Mailing address

2229 Juliesse Ave
Sacramento, CA 95821-4628
Phone (916) 765-0456

Other names 1

  • Jessica Herrlin Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1396202164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 JULIESSE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214628",
            "telephone_number": "916-765-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 FOXFIRE DR",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953376695",
            "telephone_number": "916-765-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "JESSICA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-21-55421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HERRLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.