Provider Demographics
NPI:1437570272
Name:MYLES, JINEEN (BA, MSA)
Entity Type:Individual
Prefix:
First Name:JINEEN
Middle Name:
Last Name:MYLES
Suffix:
Gender:F
Credentials:BA, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43223 GADSDEN AVE APT Q128
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6177
Mailing Address - Country:US
Mailing Address - Phone:661-547-2339
Mailing Address - Fax:
Practice Address - Street 1:1007 W. M-14 STE. C
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551
Practice Address - Country:US
Practice Address - Phone:661-947-9554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst