MEDICARE: JENNIFER AROS 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
1	103K00000X	Behavior Analyst		CA
2	103K00000X	Behavior Analyst	1-19-37440	CA

General Provider Information

NPI Number	:	1558772251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER AROS BCBA

Provider Business Mailing Address
First Line	:	2 PADRE PKWY STE 101
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-2114
Country	:	US
Telephone Number	:	707-553-1784
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 PADRE PKWY STE 101
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-2114
Country	:	US
Telephone Number	:	707-553-1784
Fax Number	:

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

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	12/28/2020

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