Provider Demographics
NPI:1508468315
Name:RYBNIKAR, JESSICA SALZA PD
Entity Type:Individual
Prefix:
First Name:JESSICA SALZA
Middle Name:PD
Last Name:RYBNIKAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24301 SOUTHLAND DR STE 510
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-1540
Mailing Address - Country:US
Mailing Address - Phone:925-915-0610
Mailing Address - Fax:
Practice Address - Street 1:24301 SOUTHLAND DR STE 510
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1540
Practice Address - Country:US
Practice Address - Phone:259-150-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician