MEDICARE: ANNIKA ALCON

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
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1649098401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIKA ALCON

Provider Business Mailing Address
First Line	:	1891 EFFIE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-1711
Country	:	US
Telephone Number	:	323-644-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1891 EFFIE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-1711
Country	:	US
Telephone Number	:	323-644-2000
Fax Number	:

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

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	12/01/2025

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Directions to “ ANNIKA ALCON ” Practice Location

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