MEDICARE: JACKLINE NABADDA

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	:	1730012592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKLINE NABADDA

Provider Business Mailing Address
First Line	:	2550 N HOLLYWOOD WAY STE 301
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-5025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CUMMINGS CTR STE 146Q
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-6135
Country	:	US
Telephone Number	:	866-727-8274
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ JACKLINE NABADDA ” Practice Location

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