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NPI Code Detail

MEDICARE: JENNA MARIE STANTON BCBA

MEDICARE: JENNA MARIE STANTON BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-25-79284CA

General Provider Information

NPI Number : 1053126367
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA MARIE STANTON BCBA
Provider Business Mailing Address
First Line : 15950 OAKRIDGE RD
Second Line :
City : MORGAN HILL
State : CA
Zip : 95037-6828
Country : US
Telephone Number : 408-694-8147
Fax Number :
Provider Business Practice Location Address
First Line : 20555 PROSPECT RD
Second Line :
City : CUPERTINO
State : CA
Zip : 95014-5212
Country : US
Telephone Number : 650-930-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2025
Last Update Date : 02/12/2025

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