Healthcare Provider Details

I. General information

NPI: 1285494583
Provider Name (Legal Business Name): L&L BEHAVIORAL AND PSYCHIATRIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 W TEAGUE AVE
FRESNO CA
93711-6072
US

IV. Provider business mailing address

15005 KILLION ST
SHERMAN OAKS CA
91411-3641
US

V. Phone/Fax

Practice location:
  • Phone: 985-789-1245
  • Fax:
Mailing address:
  • Phone: 818-259-5871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LARA VASILJKA RIMASSA
Title or Position: CEO/FOUNDER
Credential: M.S., BCBA
Phone: 985-789-1245