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NPI Code Detail

MEDICARE: JESSICA LYNDA BARRERA GARCIA BCBA,LBA

MEDICARE: JESSICA LYNDA BARRERA GARCIA BCBA,LBA
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
1106E00000XAssistant Behavior AnalystLABA0302NV
2103K00000XBehavior AnalystLBA0526NV

General Provider Information

NPI Number : 1417316019
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LYNDA BARRERA GARCIA BCBA,LBA
Provider Business Mailing Address
First Line : 2216 MORNINGLORY DR
Second Line :
City : SPARKS
State : NV
Zip : 89434-3500
Country : US
Telephone Number : 775-250-0746
Fax Number :
Provider Business Practice Location Address
First Line : 3785 BAKER LN
Second Line :
City : RENO
State : NV
Zip : 89509-5453
Country : US
Telephone Number : 209-505-0634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2016
Last Update Date : 10/14/2024

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