Provider Demographics
NPI:1184866261
Name:STAHL, JAIME ANN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:ANN
Last Name:STAHL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:ANN
Other - Last Name:BAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18350 MOUNT LANGLEY ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6923
Mailing Address - Country:US
Mailing Address - Phone:714-965-2324
Mailing Address - Fax:
Practice Address - Street 1:18350 MOUNT LANGLEY ST STE 105
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6923
Practice Address - Country:US
Practice Address - Phone:714-965-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-07-3352103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst