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General NPI Number Information
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NPI Number | 1407739741
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Entity Type | Individual
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Provider Name | LILIENNE JOSEPHINE BAZEL B.A.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 15760 VENTURA BLVD STE 1060
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City | ENCINO
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State | CA
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Zip | 91436-3065
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Country | US
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Telephone | 818-788-2388
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Fax |
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Provider Business Mailing Address
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Address Line | 17933 MEDLEY DR
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City | ENCINO
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State | CA
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Zip | 91316-4342
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Country | US
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Telephone | 818-416-5776
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CA
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