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Individual

MRS. JESSICA REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA / RBT

Contact information

Practice address
5641 SAINT ANDREWS DR, STOCKTON, CA 95219-1928
(209) 559-0861
Mailing address
1514 MANIAGO DR, STOCKTON, CA 95206-3883
(209) 559-0861

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
247200000X
Other Technician
Primary

Other

Enumeration date
04/20/2019
Last updated
04/20/2019
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