Jack Connolly

Behavior Technician · La Mesa, CA

Individual Active NPI

NPI number 1063232130

Practice location

4700 Spring St
La Mesa, CA 91942-0263
Phone
(619) 782-0700

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NPI record

NPI
1063232130
Entity type
Individual (Type 1)
Enumeration date
October 14, 2024
Last updated
October 14, 2024
Certified
October 14, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Technician Primary 106S00000X RBT-24-384528 CA

Mailing address

8030 La Mesa Blvd Ste 25
La Mesa, CA 91942-0335

About Jack Connolly

Jack Connolly is a healthcare provider registered in the NPI registry with the primary taxonomy Behavior Technician (code 106S00000X). The practice location is 4700 Spring St, La Mesa, CA 91942-0263. The NPI number 1063232130 was assigned on October 14, 2024 and the record was last updated on October 14, 2024.

Jack Connolly lists a license in the registry: #RBT-24-384528 (CA) for Behavior Technician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jack Connolly?

The NPI number is 1063232130.

What is the phone number of Jack Connolly?

The phone number listed for the practice location is (619) 782-0700.

Where is Jack Connolly located?

4700 Spring St, La Mesa, CA 91942-0263.

What is the taxonomy code for Jack Connolly?

The primary taxonomy code is 106S00000X – Behavior Technician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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