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NPI Code Detail

MEDICARE: LISA MARIE BYRNE BCBA

MEDICARE: LISA MARIE BYRNE 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 Analyst1-12-12653

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-12-12653OTHERBCBA CERTIFICATION

General Provider Information

NPI Number : 1952655987
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE BYRNE BCBA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Provider Business Practice Location Address
First Line : 333 UNIVERSITY AVENUE
Second Line : SUITE 200
City : SACRAMENTO
State : CA
Zip : 95825-6540
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2012
Last Update Date : 02/13/2026

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