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NPI Code Detail

MEDICARE: JARRED M MYREN M.ED

MEDICARE: JARRED M MYREN M.ED
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
1103K00000XBehavior Analyst1-18-31990CA

General Provider Information

NPI Number : 1619433190
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARRED M MYREN M.ED
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 27502 AVENUE SCOTT
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91355-3911
Country : US
Telephone Number : 661-670-2999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2019
Last Update Date : 05/12/2022

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