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General NPI Number Information
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NPI Number | 1861006199
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Entity Type | Individual
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Provider Name | JESSICA YVONNE CAMACHO MA, BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 14423 W MCDOWELL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2517
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Country | US
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Telephone | 623-303-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 12729 W WELLS ST
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City | EL MIRAGE
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State | AZ
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Zip | 85335-4924
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Country | US
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Telephone | 623-755-4917
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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 | BEH-001216
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License Number State | AZ
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