Active NPI
Lisa Sophia Lin
- Behavior Technician
- Tustin, CA
National Provider Identifier
1457978447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1213 Aviator LN S
Tustin, CA 92782-1701 - Phone
- (949) 412-5939
- NPI assigned
- Jun 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1213 Aviator LN S
Tustin, CA 92782-1701
Mailing address
1213 Aviator LN S
Tustin, CA 92782-1701
Other practice location 1
1465 30th St Ste K
San Diego, CA 92154-3497
Phone (619) 428-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Kids LLC | Behavior Technician | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1457978447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 AVIATOR LN S",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927821701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 AVIATOR LN S",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927821701",
"telephone_number": "949-412-5939"
}
],
"practiceLocations": [
{
"address_1": "1465 30th St Ste K",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921543497",
"country_code": "US",
"telephone_number": "619-428-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIN",
"first_name": "LISA",
"middle_name": "SOPHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-25",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.