Provider Demographics
NPI:1477006955
Name:GALLIANO, LYNN ELYSE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ELYSE
Last Name:GALLIANO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 SAINT ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6058
Mailing Address - Country:US
Mailing Address - Phone:925-212-2768
Mailing Address - Fax:
Practice Address - Street 1:4024 SAINT ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6058
Practice Address - Country:US
Practice Address - Phone:925-212-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst