Jacob Chacon

Individual provider Active NPI Behavior Technician · Ontario, CA

NPI 1952153306 · NPPES record last updated Apr 1, 2024

Key facts

NPI
1952153306
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1500 S Haven Ave
Ontario, CA 91761-2969
Phone
(909) 749-5204
NPI assigned
Apr 1, 2024
Sex
Male
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 Technician 106S00000X Yes

Addresses

Primary practice location

1500 S Haven Ave
Ontario, CA 91761-2969

Mailing address

1512 Jellick Ave Apt B
Rowland Heights, CA 91748-2026
Phone (626) 527-5740

Other providers in Ontario, CA

All providers in Ontario, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.