Provider Demographics
NPI:1255655395
Name:SLEICHTER, JENNA E (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:JENNA
Middle Name:E
Last Name:SLEICHTER
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 1:6120 DECENA DR UNIT 207
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-3558
Mailing Address - Country:US
Mailing Address - Phone:619-325-9302
Mailing Address - Fax:
Practice Address - Street 1:6120 DECENA DR UNIT 207
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-3558
Practice Address - Country:US
Practice Address - Phone:619-325-9302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst