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NPI Code Detail

MEDICARE: TYLER NA-NAKORNPANOM

MEDICARE: TYLER NA-NAKORNPANOM
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 Technician

General Provider Information

NPI Number : 1992647184
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER NA-NAKORNPANOM
Provider Business Mailing Address
First Line : 16600 SHERMAN WAY STE 178
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3875
Country : US
Telephone Number : 818-235-1414
Fax Number :
Provider Business Practice Location Address
First Line : 16600 SHERMAN WAY STE 178
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3875
Country : US
Telephone Number : 818-235-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ TYLER NA-NAKORNPANOM ” Practice Location

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