Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jalissa Lake

Individual provider Behavior Technician · NPI 1962991588

Jalissa Lake is a Behavior Technician in Tampa, Florida. Practices as a sole proprietor. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2
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Practice location Address checks out

4940 Northdale Blvd
Tampa, FL 33624-1075
Phone: (813) 485-8444
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1962991588
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 9, 2018
Last updated in NPPESAugust 7, 2025
Certification dateAugust 7, 2025

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