Provider Demographics
NPI:1184905028
Name:MACAIRAN, JEANNE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:MACAIRAN
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 STEVENS CREEK BLVD
Mailing Address - Street 2:STE. 230
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6759
Mailing Address - Country:US
Mailing Address - Phone:408-423-8076
Mailing Address - Fax:408-423-8077
Practice Address - Street 1:4675 STEVENS CREEK BLVD
Practice Address - Street 2:STE. 230
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6759
Practice Address - Country:US
Practice Address - Phone:408-423-8076
Practice Address - Fax:408-423-8077
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-8829103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst