Provider Demographics
NPI:1215281290
Name:FOSTER, JAKESHA K
Entity type:Individual
Prefix:
First Name:JAKESHA
Middle Name:K
Last Name:FOSTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 LANDON PRESERVE CIR APT 4206
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5038
Mailing Address - Country:US
Mailing Address - Phone:813-493-1850
Mailing Address - Fax:
Practice Address - Street 1:8270 WOODLAND CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2401
Practice Address - Country:US
Practice Address - Phone:813-417-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst