Provider Demographics
NPI:1467713305
Name:JARVIS, LEAH AMANDA (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:AMANDA
Last Name:JARVIS
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 1:9808 MARGERY AVE
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93505-1375
Mailing Address - Country:US
Mailing Address - Phone:661-754-0070
Mailing Address - Fax:
Practice Address - Street 1:9808 MARGERY AVE
Practice Address - Street 2:
Practice Address - City:CALIFORNIA CITY
Practice Address - State:CA
Practice Address - Zip Code:93505-1375
Practice Address - Country:US
Practice Address - Phone:661-754-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst