Provider Demographics
NPI:1740037894
Name:GIBBY, JOCELYN RANAE
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:RANAE
Last Name:GIBBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 TOURNEY RD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4990
Mailing Address - Country:US
Mailing Address - Phone:661-222-9901
Mailing Address - Fax:
Practice Address - Street 1:27200 TOURNEY RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4990
Practice Address - Country:US
Practice Address - Phone:661-222-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst