Individual
TAYLOR JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1317 OAKDALE RD STE 610, MODESTO, CA 95355-3365
(855) 581-0100
Mailing address
2080 N TUSTIN AVE STE B, SANTA ANA, CA 92705-7875
(855) 581-0100
(949) 709-0311
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/13/2019
Last updated
04/17/2021
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