Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | 18-49062 | CA |
NPI | 1003319427 |
---|---|
Provider Name | Jasmine Singh |
First Address | Modesto, CA 95352-5157 |
Second Address | Elk Grove, CA 95624-9476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2018 |
Last Update Date | 04/03/2019 |