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NPI Code Detail

MEDICARE: LISA NAKANO KWON BCBA

MEDICARE: LISA NAKANO KWON BCBA
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
1103K00000XBehavior Analyst1-21-51843TN

General Provider Information

NPI Number : 1851782296
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA NAKANO KWON BCBA
Provider Business Mailing Address
First Line : 562 W GRAND AVE
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-2502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 562 W GRAND AVE
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-2502
Country : US
Telephone Number : 760-691-9622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2015
Last Update Date : 04/17/2023

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Directions to “ LISA NAKANO KWON BCBA” Practice Location

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