Provider Demographics
NPI:1982564423
Name:STAMPLE, JAYLYN A (RBT)
Entity type:Individual
Prefix:
First Name:JAYLYN
Middle Name:A
Last Name:STAMPLE
Suffix:
Gender:F
Credentials:RBT
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Mailing Address - Street 1:15622 RIO BLANCO TRL
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4964
Mailing Address - Country:US
Mailing Address - Phone:209-969-4035
Mailing Address - Fax:
Practice Address - Street 1:9600 CENTER AVE STE 160
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5838
Practice Address - Country:US
Practice Address - Phone:800-434-8923
Practice Address - Fax:858-649-6012
Is Sole Proprietor?:No
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARBT-25-490905106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician