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NPI Code Detail

MEDICARE: JEZLIA CORREA

MEDICARE: JEZLIA CORREA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1720588262
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEZLIA CORREA
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 : 6145 IMPERIAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92114-4213
Country : US
Telephone Number : 619-839-0954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2018
Last Update Date : 01/27/2023

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Directions to “ JEZLIA CORREA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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