Provider Demographics
NPI:1679374292
Name:HAYNIE-MERAZ, JAURON J
Entity type:Individual
Prefix:
First Name:JAURON
Middle Name:J
Last Name:HAYNIE-MERAZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 E SIMPSON AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-5763
Mailing Address - Country:US
Mailing Address - Phone:559-894-5238
Mailing Address - Fax:
Practice Address - Street 1:1624 E SIMPSON AVE APT 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-5763
Practice Address - Country:US
Practice Address - Phone:559-894-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY6772754106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician