JESSICA DAMYANTI MAHABALI


Address: 39210 State St Ste 220, Fremont, CA 94538-1456
Phone: 5108944135

JESSICA DAMYANTI MAHABALI (NPI# 1811547086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811547086
Entity Type Individual
Full Name JESSICA DAMYANTI MAHABALI
Practice Address 39210 State St Ste 220
Fremont
CA 94538-1456
Mailing Address 7654 Linden Ct
Newark
CA 94560-2238
Practice Telephone 5108944135
Mailing Telephone 5105165016
Enumeration Date 2019-09-18
Last Update Date 2019-09-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 106S00000X Behavior Technician 461305562 CA Behavioral Health & Social Service Providers

Office Location

Street Address 39210 STATE ST STE 220
City FREMONT
State CA
Zip Code 94538-1456

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407351521 Melissa Fisher Marriage & Family Therapist 39210 State St Ste 220, Fremont, CA 94538-1456 2018-03-29
1356942874 Amanda Huang Le Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-11-02
1710588272 Karen Ashley Bryant Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-11-02
1487251856 Jamie Leigh Emery Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-10-07
1164029773 Gurpriya K Bhela Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-10-06
1225644156 Caitlin Marie Benge Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-09-16
1811503782 Britney Lien Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-09-16
1255942199 Madison Ann Romero Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-08-13
1699386052 Irene Mendez Ortega Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-08-11
1538784582 Rebecca Ascenso Behavior Technician 39210 State St Ste 220, Fremont, CA 94538-1456 2020-06-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699394460 Bay Area Kidney Care Medical Group Inc. Clinic/Center 39370 Mozart Terrace Unit 106, Fremont, CA 94538 2020-04-13
1740847284 Gloria Ann Federico Behavior Technician 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 2019-05-21
1093270688 Timothy Lorne Haynes Chiropractor 3775 Beacon Ave., Suite 200, Fremont, CA 94538 2019-02-07
1902370067 Nicole Sandoval Counselor 39155 Liberty St Suite E500, Fremont, CA 94538 2019-01-11
1497225015 Megan Galban Behavior Technician 39210 State St. Suite 220, Fremont, CA 94538 2018-11-27
1780154302 Karla Patricia Plascencia Behavior Technician 39210 State Street Suite 220, Fremont, CA 94538 2018-11-27
1215407846 Sydney J Torrens Behavior Technician 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 2018-11-27
1932676277 Jarah Harvan Psychologist 1999 Mowry Ave Ste F, Fremont, CA 94538 2018-10-24
1205321965 Chien Shien Yang Md Inc Psychiatry & Neurology 1860 Mowry Ave Ste 301a, Fremont, CA 94538 2018-06-26
1912416199 Advanced Interventional Surgical Center Clinic/Center 3077 Stevenson Blvd, Fremont, CA 94538 2017-09-20
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Taxonomy Information

Taxonomy Code 106S00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavior Technician

Taxonomy Definition

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225639057 Rebecca Quinones Behavior Technician 4434 Kennett Ter, Fremont, CA 94536-5735 2020-11-06
1013516715 Kearndeep Kaur Behavior Technician 34769 Comstock Cmn, Fremont, CA 94555-2819 2020-10-22
1689289548 Ina Gonzalez Behavior Technician 39210 State St Ste 204, Fremont, CA 94538-1456 2020-09-08
1184238420 Samantha Padilla Behavior Technician 39201i State St, Fremont, CA 94538-1437 2020-09-03
1215556238 Rochelle Anne Dizon Rufo Behavior Technician 4593 Hansen Ave, Fremont, CA 94536-5767 2020-04-09
1346874419 Tiffany Lillian Chen Behavior Technician 43231 Fresco Ter, Fremont, CA 94539-5885 2020-02-27
1417589888 Alicia Luna Behavior Technician 3340 Walnut Ave Ste 290, Fremont, CA 94538-2215 2020-02-04
1447890256 Nicolas Yoshio Jimenez Behavior Technician 1133 Auburn St Ste 20, Fremont, CA 94538-7329 2020-01-09
1902444953 Jasnoor Kaur Behavior Technician 4128 Fairwood St, Fremont, CA 94538-6013 2019-12-19
1891333951 Humaiza Naveed Behavior Technician 4737 Thornton Ave, Fremont, CA 94536-6462 2019-12-19
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Competitor

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City FREMONT
Zip Code 94538

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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