Healthcare Provider Details

I. General information

NPI: 1649117599
Provider Name (Legal Business Name): JESSICA TAYLOR HARTSON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR HARTSON BCBA

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10575 MAHONEY DR
SUNLAND CA
91040-1215
US

IV. Provider business mailing address

10575 MAHONEY DR
SUNLAND CA
91040-1215
US

V. Phone/Fax

Practice location:
  • Phone: 737-305-9056
  • Fax:
Mailing address:
  • Phone: 737-305-9056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: