Most Relevant Information
Provider Data
| NPI Number: | 1003650201 |
| Provider Name: | THAON KAY JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/21/2024 |
| Last Updated: | 06/21/2024 |
Provider Practice Location
7940 BANCROFT AVE APT 8
OAKLAND
CA
946053267
Practice Location Phone/Fax
| Phone: | 5105659025 |
| Fax: |
Provider Mailing Location
7940 BANCROFT AVE APT 8
OAKLAND
CA
946053267
Provider Mailing Phone/Fax
| Phone: | 5105659025 |
| Fax: |