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NPI Code Detail

MEDICARE: JESSICA PEREIRA BCBA

MEDICARE: JESSICA PEREIRA 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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-23-67568TX

General Provider Information

NPI Number : 1497247795
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA PEREIRA BCBA
Provider Business Mailing Address
First Line : 9803 LUM LN
Second Line :
City : HOUSTON
State : TX
Zip : 77078-3114
Country : US
Telephone Number : 832-875-4472
Fax Number :
Provider Business Practice Location Address
First Line : 18401 TIMBER FOREST DR
Second Line :
City : HUMBLE
State : TX
Zip : 77346-2535
Country : US
Telephone Number : 281-852-0501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2018
Last Update Date : 08/15/2023

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