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NPI Code Detail

MEDICARE: JESEY RIVERA GOPEZ BCBA, LBA

MEDICARE:   JESEY  RIVERA GOPEZ  BCBA, LBA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1942813043
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESEY RIVERA GOPEZ BCBA, LBA
Provider Business Mailing Address
First Line : 7101 N GREEN BAY AVE
Second Line :
City : GLENDALE
State : WI
Zip : 53209-2800
Country : US
Telephone Number : 262-232-4964
Fax Number : 414-797-0043
Provider Business Practice Location Address
First Line : 7101 N GREEN BAY AVE
Second Line :
City : GLENDALE
State : WI
Zip : 53209-2800
Country : US
Telephone Number : 262-232-4964
Fax Number : 414-797-0043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 02/04/2026

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Directions to “ JESEY RIVERA GOPEZ BCBA, LBA” Practice Location

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