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Individual
DR. JESSICA L TAVERNITI
Active
Individual
DR. JESSICA L TAVERNITI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D, BCBA-D
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8560
CA
103TC0700X
Clinical Psychologist
Primary
PSY 26598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-11-8560
BEHAVIOR ANALYST CERTIFICATION BOARD
—
01
—
PSY 26598
PSYCHOLOGY BOARD
CA
01
—
PSY-PSY-LIC-3580
PSYCHOLOGY BOARD
MT
Enumeration date
09/19/2011
Last updated
08/30/2022
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