MEDICARE: PARKER SHIRLEY

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	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1730986316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARKER SHIRLEY

Provider Business Mailing Address
First Line	:	4856 W ADAMS BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-2846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 S FREMONT AVE BLDG A-10
Second Line	:	SUITE C10100
City	:	ALHAMBRA
State	:	CA
Zip	:	91803-8800
Country	:	US
Telephone Number	:	336-254-9942
Fax Number	:

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

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	01/22/2026

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Directions to “ PARKER SHIRLEY ” Practice Location

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