JESSICA PARK (NPI# 1790258184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790258184 |
| Entity Type | Individual |
| Full Name | JESSICA PARK |
| Practice Address |
3443 Lilly Rd Ne Ste B Olympia WA 98506-3091 |
| Practice Telephone | 3604562237 |
| Mailing Telephone | 3604562237 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720481617 | Jessica Jin Hee Park | Pharmacist | 12105 Falcon Crest Way, Porter Ranch, CA 91326-3896 | 2014-10-06 |
| 1942808837 | Jessica Elizabeth Park | Counselor | 3402 Washington Rd Ste 304, Mc Murray, PA 15317-2964 | 2020-10-13 |
| 1902422488 | Jessica Park | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-06-22 |
| 1184244113 | Jessica Hyunji Park | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-20 |
| 1235620428 | Jessica Erin Park | Registered Nurse | 132 Abigail Lane, Port Matilda, PA 16870-7153 | 2018-05-23 |
| 1487197885 | Jessica Park | Optometrist | 7700 W Arrowhead Towne Ctr, Suite 1136, Glendale, AZ 85308-8616 | 2016-12-02 |
| 1033581905 | Jessica Park | Pharmacist | 1833 N Milpitas Blvd, Milpitas, CA 95035-2734 | 2015-10-30 |
| 1285010603 | Jessica Park | Pharmacist | 6432 Losee Rd, North Las Vegas, NV 89086-0100 | 2015-08-07 |
| 1750676292 | Jessica L. Park | Pharmacist | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2011-06-13 |
| 1851568380 | Jessica G. Park | Physician Assistant | 1600 W Avenue J, Lancaster, CA 93534-2814 | 2008-05-14 |
| Street Address |
3443 LILLY RD NE STE B |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-3091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164938338 | Alexa Danielle Foster | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2017-12-23 |
| 1235746595 | Ginaly M Osorio | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-09-30 |
| 1366059842 | Sophie G Parody | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-09-28 |
| 1821601766 | Clara Elaine Wagner | Behavioral Analyst | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-08-29 |
| 1013534858 | Natalie West | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-06-27 |
| 1861017816 | Jordan Maya Solomon | Behavioral Analyst | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-06-15 |
| 1548883861 | Sisam Acharya | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-05-20 |
| 1427670074 | Jenna Eidenmuller | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-05-16 |
| 1871115865 | Savannah Renee Johnson | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-05-12 |
| 1508487208 | Justine Kelly Jones | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929998 | Aaliyah Raheemah Imran | Behavior Technician | 4211 20th Ln Ne, Olympia, WA 98516-3730 | 2019-12-18 |
| 1659918506 | Ji Ahn | Behavior Technician | 3411 22nd Way Ne, Olympia, WA 98506-7010 | 2019-12-10 |
| 1992354542 | Genesis Saulsman | Behavior Technician | 1800 Cooper Pt Rd Sw Ste 21, Olympia, WA 98502-1179 | 2019-09-06 |
| 1649750357 | Lauren Waldinger | Behavior Technician | 600 Boulevard Rd Se Unit A, Olympia, WA 98501-1911 | 2018-08-21 |
| 1164938338 | Alexa Danielle Foster | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2017-12-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1346840048 | Eduardo Vargas | Behavior Technician | 1800 Cooper Point Rd Sw Ste 21, Olympia, WA 98502-1179 | 2020-10-30 |
| 1427658111 | Mariah Brooke Foster | Behavior Technician | 1800 Cooper Point Rd Sw Ste 21, Olympia, WA 98502-1179 | 2020-10-30 |
| 1265031058 | Vernelle Whitney Whetstone-miranda | Behavior Technician | 1800 Cooper Point Rd Sw Ste 21, Olympia, WA 98502-1179 | 2020-10-22 |
| 1235746595 | Ginaly M Osorio | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2020-09-30 |
| Find all providers in OLYMPIA | ||||
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| 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.