Provider Demographics
NPI:1033458302
Name:MCGEE, JENNIFER LORI (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LORI
Last Name:MCGEE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 CURRAN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-2035
Mailing Address - Country:US
Mailing Address - Phone:323-839-5968
Mailing Address - Fax:
Practice Address - Street 1:1553 CURRAN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-2035
Practice Address - Country:US
Practice Address - Phone:323-839-5968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12592103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst