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NPI Code Detail

MEDICARE: JAKE RASMUSSEN

MEDICARE: JAKE RASMUSSEN
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 Analyst
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1285150391
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAKE RASMUSSEN
Provider Business Mailing Address
First Line : 24 W SERGEANT COURT DR STE 204
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5809
Country : US
Telephone Number : 801-987-6333
Fax Number :
Provider Business Practice Location Address
First Line : 24 W SERGEANT COURT DR STE 204
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5809
Country : US
Telephone Number : 801-987-6333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2017
Last Update Date : 02/05/2026

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Directions to “ JAKE RASMUSSEN ” Practice Location

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