Individual
CARLENNE LACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3355 MISSION AVE STE 221, OCEANSIDE, CA 92058-1328
(951) 813-4034
(951) 813-4035
Mailing address
26720 YNEZ CT, TEMECULA, CA 92591-4659
(951) 813-4034
(951) 813-4035
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60843
CA
106E00000X
Assistant Behavior Analyst
0-21-12673
CA
106S00000X
Behavior Technician
RBT-16-17023
CA
Other
Enumeration date
01/23/2018
Last updated
08/17/2022
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