MEDICARE: ALLISON LENZORA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-21-54346	CA

General Provider Information

NPI Number	:	1417458761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON LENZORA

Provider Business Mailing Address
First Line	:	PO BOX 33568
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-3568
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 N TRACY BLVD STE 202
Second Line	:
City	:	TRACY
State	:	CA
Zip	:	95376-7767
Country	:	US
Telephone Number	:	209-521-4791
Fax Number	:	209-521-4794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2018
Last Update Date	:	09/18/2023

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Directions to “ ALLISON LENZORA ” Practice Location

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