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General NPI Number Information
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NPI Number | 1598162851
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Entity Type | Individual
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Provider Name | BRIAN A. JENKINS M.S. PSYCHOLOGY
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Gender | Male
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 07/04/2016
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Provider Practice Location Address
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Address Line | 31126 VARNI PL
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City | UNION CITY
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State | CA
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Zip | 94587-2638
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Country | US
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Telephone | 510-610-0725
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Fax |
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Provider Business Mailing Address
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Address Line | 31126 VARNI PL
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City | UNION CITY
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State | CA
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Zip | 94587-2638
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Country | US
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Telephone | 510-610-0725
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-16-22767
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License Number State | CA
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