Provider Demographics
NPI:1922472307
Name:FRANCISCO, JOMERENE (BA)
Entity Type:Individual
Prefix:
First Name:JOMERENE
Middle Name:
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4387 ARROWWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4428
Mailing Address - Country:US
Mailing Address - Phone:925-597-9038
Mailing Address - Fax:
Practice Address - Street 1:2010 CROW CANYON PL
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4634
Practice Address - Country:US
Practice Address - Phone:510-999-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-22
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-15-05749103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst