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NPI Code Detail

MEDICARE: PRISCILA JASSO

MEDICARE:   PRISCILA  JASSO
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

General Provider Information

NPI Number : 1255264123
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILA JASSO
Provider Business Mailing Address
First Line : 1460 GAVIOTA AVE APT 4
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-2489
Country : US
Telephone Number : 805-422-9185
Fax Number :
Provider Business Practice Location Address
First Line : 1460 GAVIOTA AVE APT 4
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-2489
Country : US
Telephone Number : 805-422-9185
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ PRISCILA JASSO ” Practice Location

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