Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 103K0000X - BEHAVIOR | CA |
NPI | 1114467115 |
---|---|
Provider Name | Lu Shibli I |
First Address | Burlingame, CA 94010 |
Second Address | Burlingame, CA 94401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2017 |
Last Update Date | 24/02/2017 |