Provider Demographics
NPI:1972921310
Name:MOSCHELLA, JONPAUL (BCBA-M)
Entity type:Individual
Prefix:
First Name:JONPAUL
Middle Name:
Last Name:MOSCHELLA
Suffix:
Gender:M
Credentials:BCBA-M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 N CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-1852
Mailing Address - Country:US
Mailing Address - Phone:559-278-6773
Mailing Address - Fax:559-278-0015
Practice Address - Street 1:4910 N CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-1852
Practice Address - Country:US
Practice Address - Phone:559-278-6773
Practice Address - Fax:559-278-0015
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst