Individual provider · Type 1 NPI

Lisette Broussard, BCBA

Behavior Analyst · San Diego, CA

NPI number 1417512658 Active

Practice location

501 W Broadway, Ste 800
San Diego, CA 92101

Call (855) 832-6727 Map

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997

Specialties and licenses

Taxonomy	Code	License
Behavior Analyst Primary	103K00000X	1-21-51914 (CA)

Behavior Analyst: A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis…

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About NPI 1417512658

Lisette Broussard, BCBA's National Provider Identifier is 1417512658, issued on May 2, 2019. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in San Diego, CA. The record was last updated on Mar 1, 2026.