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NPI Code Detail

MEDICARE: TYLER JACOB SALES

MEDICARE: TYLER JACOB SALES
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 AnalystCA

General Provider Information

NPI Number : 1659012078
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER JACOB SALES
Provider Business Mailing Address
First Line : DEPT LA 227763
Second Line :
City : PASADENA
State : CA
Zip : 91185-2763
Country : US
Telephone Number : 866-523-4268
Fax Number :
Provider Business Practice Location Address
First Line : 3620 W HAMMER LN
Second Line :
City : STOCKTON
State : CA
Zip : 95219-5532
Country : US
Telephone Number : 866-523-4268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2022
Last Update Date : 03/09/2026

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Directions to “ TYLER JACOB SALES ” Practice Location

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