Healthcare Provider Details

I. General information

NPI: 1336459676
Provider Name (Legal Business Name): JARRETT KYLE WILLIAMS HAUPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 MCGAW AVE STE 100
IRVINE CA
92614-5554
US

IV. Provider business mailing address

1619 ELEMENTS WAY
IRVINE CA
92612-6573
US

V. Phone/Fax

Practice location:
  • Phone: 714-363-8254
  • Fax:
Mailing address:
  • Phone: 775-378-3507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: