MEDICARE: LINDSAY FOLLIOTT

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	2355S0801X	Speech-Language Assistant	2751	CA
2	103K00000X	Behavior Analyst	1-17-27230	CA

General Provider Information

NPI Number	:	1942604434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY FOLLIOTT

Provider Business Mailing Address
First Line	:	16782 VON KARMAN AVE STE 11
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92606-2417
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:	619-374-7134

Provider Business Practice Location Address
First Line	:	6177 N THESTA ST STE 103
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-8600
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:	619-374-7134

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

Provider Enumeration Date	:	10/13/2014
Last Update Date	:	07/21/2022

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Directions to “ LINDSAY FOLLIOTT ” Practice Location

Language	Start Address	Practice Location

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