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Jackson Rasim Enyeart

Behavior Technician in Concord, CA. Individual provider (NPI-1).

NPI number1245096437
StatusActive
Last updated in NPPESFeb 26, 2024

Details

NPI
1245096437
Entity type
Individual (NPI-1)
Name
Jackson Rasim Enyeart
Sex
Male
Sole proprietor
No
Enumeration date
Feb 26, 2024
Certification date
Feb 25, 2024
Last updated
Feb 26, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

1200 Concord Ave
Concord, CA 94520-4915

Phone 877-920-6538

Mailing address

1200 Concord Ave
Concord, CA 94520-4915

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