Healthcare Provider Details

I. General information

NPI: 1457299760
Provider Name (Legal Business Name): JADE HANNAH MCBRIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CHERRY LN
MANTECA CA
95337-4395
US

IV. Provider business mailing address

250 CHERRY LN
MANTECA CA
95337-4395
US

V. Phone/Fax

Practice location:
  • Phone: 209-210-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: