MEDICARE: JASPREET JAGPAL 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	1-16-22144	CA

General Provider Information

NPI Number	:	1356793103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASPREET JAGPAL BCBA

Provider Business Mailing Address
First Line	:	686 SHANGHAI BEND RD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-8326
Country	:	US
Telephone Number	:	530-329-6368
Fax Number	:	530-671-7866

Provider Business Practice Location Address
First Line	:	686 SHANGHAI BEND RD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-8326
Country	:	US
Telephone Number	:	530-329-6368
Fax Number	:	530-671-7866

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

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	07/05/2016

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