Provider Demographics
NPI:1235605460
Name:KOST, JAYDE NARIKO (RBT)
Entity Type:Individual
Prefix:
First Name:JAYDE
Middle Name:NARIKO
Last Name:KOST
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 S YORBA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-5052
Mailing Address - Country:US
Mailing Address - Phone:714-222-4550
Mailing Address - Fax:
Practice Address - Street 1:4001 WESTERLY PL
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2315
Practice Address - Country:US
Practice Address - Phone:949-756-8799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician