Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | F7717262 | CA |
NPI | 1003394727 |
---|---|
Provider Name | Jazzmyn Sierra Seay-Jackson |
First Address | Hayward, CA 94541-4113 |
Second Address | Hayward, CA 94541-4113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2018 |
Last Update Date | 21/06/2019 |