Healthcare Provider Details

I. General information

NPI: 1780594598
Provider Name (Legal Business Name): EMILY LIZBETH ACOSTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8252 WHITAKER ST APT 11
BUENA PARK CA
90621-3136
US

IV. Provider business mailing address

8252 WHITAKER ST APT 11
BUENA PARK CA
90621-3136
US

V. Phone/Fax

Practice location:
  • Phone: 714-391-3966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: