Provider Demographics
NPI:1205296332
Name:DEMING, JODIE ELIZABETH (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:JODIE
Middle Name:ELIZABETH
Last Name:DEMING
Suffix:
Gender:F
Credentials:PHD, BCBA-D
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Mailing Address - Street 1:5435 BALBOA BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1508
Mailing Address - Country:US
Mailing Address - Phone:310-993-4499
Mailing Address - Fax:310-933-4134
Practice Address - Street 1:170 COMMERCE WAY STE 200
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3272
Practice Address - Country:US
Practice Address - Phone:603-609-7600
Practice Address - Fax:603-609-0688
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2021-09-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3119318Medicaid