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General NPI Number Information
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NPI Number | 1427691567
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Entity Type | Individual
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Provider Name | OPHELIA RAYCHELLE LINDLEY
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Gender | Female
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 14124 PRAIRIE AVE
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City | HAWTHORNE
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State | CA
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Zip | 90250-7906
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Country | US
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Telephone | 682-344-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 4781 N POLK AVE APT 195
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City | FRESNO
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State | CA
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Zip | 93722-5344
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Country | US
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Telephone | 951-380-0780
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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 | RBT-19-101910
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State | TX
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