Individual provider · NPI-1

Jenna Bush, BCBA

Behavior Analyst · Valley Village, CA

NPI number1255824751
StatusActive
Last updated in NPPESJun 8, 2018

Details

NPI
1255824751
Entity type
Individual (NPI-1)
Name
Jenna Bush
Credential
BCBA
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 8, 2018
Last updated
Jun 8, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior AnalystCERT-1-18-30110CAYes

Practice location

5318 Laurel Canyon Blvd Ste 101
Valley Village, CA 91607-4928

Phone 818-423-2215

Mailing address

5318 Laurel Canyon Blvd Ste 101
Valley Village, CA 91607-4928

Phone 818-423-2215

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