Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LARISSA FEDRA KOUTAKOS
ActiveLARISSA FEDRA KOUTAKOS is a Behavior Analyst healthcare provider located in MARINA, California. NPI 1245866011 is currently active in the NPPES registry. Verify at CMS.
Behavior Analyst · MARINA, CA
Registration Details
- NPI Number
- 1245866011
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 12, 2020 (6.2409026040555 yrs)
- Last Updated
- Jan 21, 2022
- License
-
1-15-20710
Practice Information
- Address
-
3180 IMJIN RD STE 149MARINA, CA, 939335111Browse CA providers · Browse ZIP 93933
- Phone
- 8317860600
- Primary Specialty
-
Behavior Analyst
103K00000X
Other Behavior Analyst Providers in MARINA, CA
| Name | Credential | NPI |
|---|---|---|
| AMANDA SWIFT | B.C.B.A. | 1982091013 |
| AMBER S CLAYTON | BCBA | 1942720602 |
| FLORENCIA GENTINETTA BALDWIN | BCBA | 1639694839 |
| AMBER JEAN CASTAGNA | MA BCBA | 1306353040 |
| YI YU | BCBA | 1336631431 |
| DASY NALLELY JUAREZ | — | 1588157655 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.