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NPI Code Detail

MEDICARE: JASON FERMIN II

MEDICARE: JASON FERMIN II
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

General Provider Information

NPI Number : 1689305005
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON FERMIN II
Provider Business Mailing Address
First Line : 1200 CONCORD AVE STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-4969
Country : US
Telephone Number : 510-268-8120
Fax Number :
Provider Business Practice Location Address
First Line : 1200 CONCORD AVE STE 100
Second Line :
City : CONCORD
State : CA
Zip : 94520-4969
Country : US
Telephone Number : 510-268-8120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2022
Last Update Date : 12/29/2025

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Directions to “ JASON FERMIN II ” Practice Location

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