MEDICARE: JENNIKA LINSANGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1063061364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIKA LINSANGAN

Provider Business Mailing Address
First Line	:	5211 AUTH RD
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-4339
Country	:	US
Telephone Number	:	202-257-6632
Fax Number	:

Provider Business Practice Location Address
First Line	:	5211 AUTH RD
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-4339
Country	:	US
Telephone Number	:	202-257-6632
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	03/26/2025

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Directions to “ JENNIKA LINSANGAN ” Practice Location

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