Provider Demographics
NPI:1427327956
Name:HARRIS, JONATHAN F (BSME)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:F
Last Name:HARRIS
Suffix:
Gender:M
Credentials:BSME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 POINT WEST WAY
Mailing Address - Street 2:OPTIMAL NEUROFEEDBACK SUITE 144
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4705
Mailing Address - Country:US
Mailing Address - Phone:916-927-4741
Mailing Address - Fax:
Practice Address - Street 1:1900 POINT WEST WAY
Practice Address - Street 2:OPTIMAL NEUROFEEDBACK SUITE 144
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4705
Practice Address - Country:US
Practice Address - Phone:916-927-4741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG