Provider Demographics
NPI:1053126367
Name:STANTON, JENNA MARIE (BCBA)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIE
Last Name:STANTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15950 OAKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-6828
Mailing Address - Country:US
Mailing Address - Phone:408-694-8147
Mailing Address - Fax:
Practice Address - Street 1:20555 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5212
Practice Address - Country:US
Practice Address - Phone:650-930-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-25-79284103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst