Kabal Sriviboon

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB60816035 Issued in WA

Practice address

20818 44TH Ave W Suite 270
Lynnwood, WA 98036

Phone

(425) 712-0802

Fax

(425) 712-0641

NPI assigned

Jun 27, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1790270197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20818 44TH AVE W STE 270",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367709",
            "telephone_number": "425-712-0802",
            "fax_number": "425-712-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20818 44TH AVE W SUITE 270",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98036",
            "telephone_number": "425-712-0802",
            "fax_number": "425-712-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVIBOON",
        "first_name": "KABAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB60816035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary V Springer, RN
• Springhealth Behavioral Health and Integrated Care Washington, LLC
• Squareone Services, SPC
• Jennifer Lynn Squire, DPT
• Savita Srivastava
• Josephine Mojica St Hilaire
• Cheryl Ann St Sauver
• Catherine E. Stafford, BA, MSW, LCSW
• David E Stage, MD
• Lloyd Edwin Stambaugh III, MD

• Behavior Technician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.