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NPI Code Detail

MEDICARE: JARRAH WERTZ

MEDICARE: JARRAH WERTZ
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 Analyst

General Provider Information

NPI Number : 1790394211
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARRAH WERTZ
Provider Business Mailing Address
First Line : 982 ARTESIA BLVD
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-2707
Country : US
Telephone Number : 847-736-0323
Fax Number :
Provider Business Practice Location Address
First Line : 982 ARTESIA BLVD
Second Line :
City : HERMOSA BEACH
State : CA
Zip : 90254-2707
Country : US
Telephone Number : 310-310-2931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2020
Last Update Date : 03/24/2025

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Directions to “ JARRAH WERTZ ” Practice Location

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