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1811547086
JESSICA DAMYANTI MAHABALI
FREMONT, CA
NPI
1811547086
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA 461305562)
Enumeration Date
2019-09-18
Last Update Date
2019-09-18
Business Address
JESSICA DAMYANTI MAHABALI
39210 STATE ST STE 220
FREMONT, CA 94538-1456
Phone number: 510-894-4135
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Mailing Address
JESSICA DAMYANTI MAHABALI
7654 LINDEN CT
NEWARK, CA 94560-2238
Phone number: 510-516-5016
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