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NPI Code Detail

MEDICARE: JENNIFER CRESPO

MEDICARE:   JENNIFER  CRESPO
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1154808731
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CRESPO
Provider Business Mailing Address
First Line : PO BOX 399318
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94139-9318
Country : US
Telephone Number : 866-523-4268
Fax Number :
Provider Business Practice Location Address
First Line : 3745 LONG BEACH BLVD STE 100
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-3340
Country : US
Telephone Number : 310-787-9334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2018
Last Update Date : 09/08/2021

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Directions to “ JENNIFER CRESPO ” Practice Location

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