Provider Demographics
NPI:1497435408
Name:RICHARDSON, JAZILYN JABREE (RBT)
Entity Type:Individual
Prefix:
First Name:JAZILYN
Middle Name:JABREE
Last Name:RICHARDSON
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 1:4073 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-6460
Mailing Address - Country:US
Mailing Address - Phone:916-832-2265
Mailing Address - Fax:916-250-0557
Practice Address - Street 1:4073 DOVER ST
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-6460
Practice Address - Country:US
Practice Address - Phone:916-832-2265
Practice Address - Fax:916-250-0557
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician