Lisa Jieun Park
Behavior Technician in Los Angeles, CA. Individual provider (NPI-1).
NPI number1629763578
StatusActive
Last updated in NPPESApr 6, 2023
Details
- NPI
- 1629763578
- Entity type
- Individual (NPI-1)
- Name
- Lisa Jieun Park
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 6, 2023
- Certification date
- Apr 6, 2023
- Last updated
- Apr 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
3031 Beverly Blvd Ste 208Los Angeles, CA 90057-1013
Phone 323-644-9380 · Fax 323-644-9381
Mailing address
3031 Beverly Blvd Ste 208Los Angeles, CA 90057-1013
Phone 323-644-9380 · Fax 323-644-9381
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