Jacob Neldam-Vasqeuz

Individual provider Active NPI Behavior Analyst · Discovery Bay, CA

NPI 1992298335 · NPPES record last updated Jun 11, 2018

Key facts

NPI
1992298335
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
2068 Windward PT
Discovery Bay, CA 94505-9513
Phone
(925) 483-1752
NPI assigned
Jun 11, 2018
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 Analyst 103K00000X Yes

Addresses

Primary practice location

2068 Windward PT
Discovery Bay, CA 94505-9513

Mailing address

2068 Windward PT
Discovery Bay, CA 94505-9513
Phone (925) 483-1752

Other providers in Discovery Bay, CA

All providers in Discovery Bay, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.