Provider Demographics
NPI:1841992526
Name:SOMARRIBA, JESSICA NATASHA (RBT)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:NATASHA
Last Name:SOMARRIBA
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 1:1018 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-3045
Mailing Address - Country:US
Mailing Address - Phone:863-253-7249
Mailing Address - Fax:
Practice Address - Street 1:1018 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3045
Practice Address - Country:US
Practice Address - Phone:863-253-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB902463106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician