Cody T. Jackson

NPI #1447043773 in Granite Bay, California

Provider Information

NPI Number: 1447043773
Entity Type: Individual
Name: Cody T. Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 28, 2025
Last Updated: May 28, 2025

Practice Location

Address: 4196 DOUGLAS BLVD STE 100
City: Granite Bay
State: California
ZIP Code: 95746-5904
Phone: (916) 489-1376

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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