Provider Demographics
NPI:1003491085
Name:PARKER, AMBER KAI (RBT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:KAI
Last Name:PARKER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44428 STANRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2529
Mailing Address - Country:US
Mailing Address - Phone:760-285-7865
Mailing Address - Fax:
Practice Address - Street 1:44514 20TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2715
Practice Address - Country:US
Practice Address - Phone:661-723-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-19-107052106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician