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Individual
MR. JEFFREY KASIK
Active
Individual
MR. JEFFREY KASIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41374
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27BW8
MEDI-CAL
CA
01
—
41BW
MEDI-CAL
CA
01
—
BWASOCFSP
MEDI-CAL
CA
01
—
D4349506
DRIVER LICENSE
CA
01
—
PRVNBR
MEDI-CAL
CA
Enumeration date
07/29/2011
Last updated
12/28/2023
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