Provider Demographics
NPI:1114288263
Name:STIEGEMEYER, JODY (BCBA)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:STIEGEMEYER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27240 TURNBERRY LN STE 240
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1017
Mailing Address - Country:US
Mailing Address - Phone:661-254-7086
Mailing Address - Fax:661-254-7108
Practice Address - Street 1:27240 TURNBERRY LN STE 240
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1017
Practice Address - Country:US
Practice Address - Phone:661-254-7086
Practice Address - Fax:661-254-7108
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-6555103K00000X
CASP 12292235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist