MEDICARE: GRACIE LEANN LAU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1255282158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACIE LEANN LAU

Provider Business Mailing Address
First Line	:	5701 YOUNG ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-8896
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 YOUNG ST
Second Line	:	UNIT STE 400, BLDG. A
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-8896
Country	:	US
Telephone Number	:	833-831-8946
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ GRACIE LEANN LAU ” Practice Location

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