Provider Demographics
NPI:1053857490
Name:HIVELY, JOCELYN (EDD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:
Last Name:HIVELY
Suffix:
Gender:F
Credentials:EDD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 ROSEDALE HWY
Mailing Address - Street 2:SUITE 302-189
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6170
Mailing Address - Country:US
Mailing Address - Phone:661-228-0280
Mailing Address - Fax:
Practice Address - Street 1:5100 CALIFORNIA AVENUE
Practice Address - Street 2:SUITES 101 AND 125
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-228-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18326103K00000X
CALEP3701103T00000X
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool