Healthcare Provider Details

I. General information

NPI: 1700722394
Provider Name (Legal Business Name): JENNIFER CASAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 W 14TH LN
YUMA AZ
85364-8613
US

IV. Provider business mailing address

4409 W 14TH LN
YUMA AZ
85364-8613
US

V. Phone/Fax

Practice location:
  • Phone: 909-838-9009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: