=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205741584
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENIFER YAZMIN TEREZA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2026
-----------------------------------------------------
Last Update Date | 08/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27555 YNEZ RD STE 300
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92591-4678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-694-0100
-----------------------------------------------------
Fax | 877-748-8796
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25595 SIERRA CADIZ CT
-----------------------------------------------------
City | MORENO VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92551-4100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-521-3923
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------