MEDICARE: JESSICA L SNEATH

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1841872108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L SNEATH

Provider Business Mailing Address
First Line	:	6240 BRECKINRIDGE LN
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-6606
Country	:	US
Telephone Number	:	951-218-3358
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 BRECKINRIDGE LN
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-6606
Country	:	US
Telephone Number	:	951-218-3358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	04/26/2021

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Directions to “ JESSICA L SNEATH ” Practice Location

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