Provider Demographics
NPI:1295292365
Name:BEJERANA, JHAYMIE LYNN SALARZON (RBT)
Entity type:Individual
Prefix:
First Name:JHAYMIE LYNN
Middle Name:SALARZON
Last Name:BEJERANA
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:PO BOX 20777
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA
Mailing Address - State:GU
Mailing Address - Zip Code:96921-0777
Mailing Address - Country:US
Mailing Address - Phone:671-489-9727
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 1350 #216
Practice Address - Street 2:
Practice Address - City:UPPER TUMON
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-487-5493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU19-79214106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician