MEDICARE: JAZMIN ARACELY PEREDA

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1326757915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZMIN ARACELY PEREDA

Provider Business Mailing Address
First Line	:	7339 N 1ST ST STE 105&110
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2954
Country	:	US
Telephone Number	:	916-740-1749
Fax Number	:

Provider Business Practice Location Address
First Line	:	6202 N BRIX AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-3311
Country	:	US
Telephone Number	:	510-461-2437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2022
Last Update Date	:	11/22/2022

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Directions to “ JAZMIN ARACELY PEREDA ” Practice Location

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