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NPI Code Detail

MEDICARE: JESSICA JEANNETTE RIOS

MEDICARE: JESSICA JEANNETTE RIOS
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 : 1982376455
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JEANNETTE RIOS
Provider Business Mailing Address
First Line : 3056 EAST ST
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-3929
Country : US
Telephone Number : 805-422-1685
Fax Number :
Provider Business Practice Location Address
First Line : 3056 EAST ST
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-3929
Country : US
Telephone Number : 805-422-1685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2021
Last Update Date : 10/01/2021

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Directions to “ JESSICA JEANNETTE RIOS ” Practice Location

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