Provider Demographics
NPI:1316679319
Name:JEW, AARON GARRICK
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:GARRICK
Last Name:JEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 POMPANO CIR
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1904
Mailing Address - Country:US
Mailing Address - Phone:650-358-8597
Mailing Address - Fax:
Practice Address - Street 1:320 POMPANO CIR
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1904
Practice Address - Country:US
Practice Address - Phone:650-358-8597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician