Provider Demographics
NPI:1972969517
Name:TEGLEY, JILL (MA, BCBA)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:TEGLEY
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 YOSEMITE LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-7324
Mailing Address - Country:US
Mailing Address - Phone:609-923-3583
Mailing Address - Fax:
Practice Address - Street 1:1337 HOWE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3361
Practice Address - Country:US
Practice Address - Phone:916-564-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst