Healthcare Provider Details

I. General information

NPI: 1013842889
Provider Name (Legal Business Name): CASSANDRA MARIE PARKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12395 LEWIS ST STE 102
GARDEN GROVE CA
92840-4698
US

IV. Provider business mailing address

5234 OLIVA AVE APT 6
LAKEWOOD CA
90712-2319
US

V. Phone/Fax

Practice location:
  • Phone: 760-634-1125
  • Fax:
Mailing address:
  • Phone: 858-352-8627
  • 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: