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NPI Code Detail

MEDICARE: KYOKO LASHELL CHARLES

MEDICARE: KYOKO LASHELL CHARLES
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
1106S00000XBehavior Technician011130605LA

General Provider Information

NPI Number : 1497302624
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYOKO LASHELL CHARLES
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 209 CENTRE SARCELLE BLVD STE 201
Second Line :
City : YOUNGSVILLE
State : LA
Zip : 70592-6755
Country : US
Telephone Number : 337-857-3674
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2019
Last Update Date : 08/22/2019

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Directions to “ KYOKO LASHELL CHARLES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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