Healthcare Provider Details

I. General information

NPI: 1568946739
Provider Name (Legal Business Name): YVONNE CHEN LAI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARNOLD RD STE 200
DUBLIN CA
94568-7724
US

IV. Provider business mailing address

24 PUEBLO ST
SAN FRANCISCO CA
94134-3142
US

V. Phone/Fax

Practice location:
  • Phone: 925-266-8023
  • Fax:
Mailing address:
  • Phone: 415-971-7823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-47242
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-18-8476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: