Provider Demographics
NPI:1407691090
Name:GURUNG, KARMA YANJIN (BCBA)
Entity type:Individual
Prefix:
First Name:KARMA
Middle Name:YANJIN
Last Name:GURUNG
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12952C GRAYS POINTE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2154
Mailing Address - Country:US
Mailing Address - Phone:304-894-4313
Mailing Address - Fax:
Practice Address - Street 1:12330 PINECREST RD STE 100
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1656
Practice Address - Country:US
Practice Address - Phone:703-574-4964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-24-73685103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst