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TRACIE LATRICE JACKSON NPI 1275181414


NPI Information

NPI: 1275181414
Provider Name: TRACIE LATRICE JACKSON
Classification: Behavior Analyst - 103K00000X
Entity Type: Individual
Address:
1274 CENTER COURT DR STE 211
COVINA, CA
ZIP 91724
Phone: (909) 231-5639
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Tracie Latrice Jackson is a behavior analyst in Covina, CA. The provider is a behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. Tracie Latrice Jackson NPI is 1275181414. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1274 CENTER COURT DR STE 211
COVINA, CA
ZIP 91724-668
Phone: (909) 231-5639

The enumeration date for this NPI number is 8/30/2019 and was last updated on 4/3/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1372600000XAdult CompanionNEVADANo
23747A0650XTechnicianAttendant Care ProviderNEVADANo
3372500000XChore ProviderNEVADANo
43747P1801XTechnicianPersonal Care AttendantNEVADANo
5376J00000XHomemakerNEVADANo
6103K00000XBehavior AnalystCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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