Provider Demographics
NPI:1720227093
Name:YI, JANET (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:YI
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ENTERPRISE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2601
Mailing Address - Country:US
Mailing Address - Phone:949-362-9952
Mailing Address - Fax:949-362-2783
Practice Address - Street 1:65 ENTERPRISE
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2601
Practice Address - Country:US
Practice Address - Phone:949-362-9952
Practice Address - Fax:949-362-2783
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-04-1850103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst