Basic Information
| Provider Information | |||||||||
| NPI: | 1972944270 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BECKER | ||||||||
| FirstName: | LYNETTE | ||||||||
| MiddleName: | |||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27240 TURNBERRY LN | ||||||||
| Address2: | 240 | ||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913551029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612547086 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 27240 TURNBERRY LN | ||||||||
| Address2: | 240 | ||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913551029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612547086 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2013 | ||||||||
| LastUpdateDate: | 07/15/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 11313514 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.