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NPI Code Detail

MEDICARE: TREVOR JASEN

MEDICARE: TREVOR JASEN
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 : 1902600893
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVOR JASEN
Provider Business Mailing Address
First Line : 236 BAY ST APT 9
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1073
Country : US
Telephone Number : 973-295-5160
Fax Number :
Provider Business Practice Location Address
First Line : 3280 MOTOR AVE STE 110
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3766
Country : US
Telephone Number : 424-672-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2025
Last Update Date : 03/24/2026

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Directions to “ TREVOR JASEN ” Practice Location

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