Healthcare Provider Details

I. General information

NPI: 1033080924
Provider Name (Legal Business Name): ADAM FRANK LEP, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7755 HAZEL AVE
ORANGEVALE CA
95662-2408
US

IV. Provider business mailing address

PO BOX 2693
GRANITE BAY CA
95746-2693
US

V. Phone/Fax

Practice location:
  • Phone: 916-953-9921
  • Fax:
Mailing address:
  • Phone: 916-953-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-35029
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3675
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: