Provider Demographics
NPI:1821553611
Name:WINDSOR, JADE (BS)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:WINDSOR
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79873 SWANSEA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-4869
Mailing Address - Country:US
Mailing Address - Phone:253-459-3075
Mailing Address - Fax:
Practice Address - Street 1:79873 SWANSEA AVE
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-4869
Practice Address - Country:US
Practice Address - Phone:253-459-3075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst