Active NPI
Jackie Jacques Daoud, BCBA
- Behavior Analyst
- San Jose, CA
National Provider Identifier
1548745235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-19-35575
- Practice address
- 1479 Saratoga Ave
San Jose, CA 95129-4934 - Phone
- (877) 991-0009
- Fax
- (818) 241-6853
- NPI assigned
- Sep 27, 2018
- Last updated
- Apr 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-19-35575 | Primary |
Addresses
Primary practice location
1479 Saratoga Ave
San Jose, CA 95129-4934
Mailing address
PO Box 767249
Roswell, GA 30076-7249
Phone (818) 241-6780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GGS879A78799 | Other | CA | ANTHEM BLUE CROSS |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Is for Apple | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1548745235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 767249",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300767249",
"telephone_number": "818-241-6780",
"fax_number": "818-241-6853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1479 SARATOGA AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951294934",
"telephone_number": "877-991-0009",
"fax_number": "818-241-6853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAOUD",
"first_name": "JACKIE",
"middle_name": "JACQUES",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-27",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-19-35575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "GGS879A78799",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.