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General NPI Number Information
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NPI Number | 1982301321
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Entity Type | Individual
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Provider Name | KAYLA SKYE DELGADO JASSO
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Gender | Female
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 1320 E SHAW AVE STE 110
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City | FRESNO
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State | CA
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Zip | 93710-7905
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Country | US
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Telephone | 808-235-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 2375 FLORAL AVE APT 106
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City | SELMA
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State | CA
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Zip | 93662-2714
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Country | US
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Telephone | 559-776-9057
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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