Healthcare Provider Details

I. General information

NPI: 1285538603
Provider Name (Legal Business Name): JOCELYN CRISTINA HENRIQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 N SULLIVAN RD, STE F 139 STE F 139
SPOKANE VALLEY WA
99037-8543
US

IV. Provider business mailing address

2723 W PENINSULA DR
MOSES LAKE WA
98837-2842
US

V. Phone/Fax

Practice location:
  • Phone: 509-760-7675
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: