Provider Demographics
NPI:1356072540
Name:SALAZAR, JESELLE CHRISTINE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:JESELLE
Middle Name:CHRISTINE
Last Name:SALAZAR
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 1:1316 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-2827
Mailing Address - Country:US
Mailing Address - Phone:562-417-9588
Mailing Address - Fax:
Practice Address - Street 1:1316 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-2827
Practice Address - Country:US
Practice Address - Phone:562-417-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-22-5912103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst