Provider Demographics
NPI:1164880365
Name:GEE, JACOB (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:GEE
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6829
Mailing Address - Country:US
Mailing Address - Phone:310-792-2877
Mailing Address - Fax:310-792-2878
Practice Address - Street 1:25500 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6829
Practice Address - Country:US
Practice Address - Phone:310-792-2877
Practice Address - Fax:310-792-2878
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA CERT#1-15-18928103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst