Provider Demographics
NPI:1609760677
Name:JASMAN, TERI BETH (BCBA)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:BETH
Last Name:JASMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5544 MERRIEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2133
Mailing Address - Country:US
Mailing Address - Phone:510-717-1719
Mailing Address - Fax:
Practice Address - Street 1:4138 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-1941
Practice Address - Country:US
Practice Address - Phone:510-717-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-1621291103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst