MEDICARE: DR. JACQUELYN MARIE MALOY M.A., BCBA

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	103K00000X	Behavior Analyst	1-12-12484	CA

General Provider Information

NPI Number	:	1265878896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELYN MARIE MALOY M.A., BCBA

Provider Business Mailing Address
First Line	:	6330 FOUNTAIN SQUARE DR UNIT 4422
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95611-5155
Country	:	US
Telephone Number	:	916-628-4802
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 FOUNTAIN SQUARE DR UNIT 4422
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95611-5155
Country	:	US
Telephone Number	:	916-628-4802
Fax Number	:

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

Provider Enumeration Date	:	05/22/2013
Last Update Date	:	12/10/2025

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