Unknown Individual – Psychiatry Physician, NPI 1083739874
Psychiatry Physician
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Profile Insights
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Provider Addresses for Unknown Individual
21201 VICTORY BOULEVARD
SUITE 200
CANOGA PARK, CA 91303
Phone: (818) 702-9339
Fax: (818) 348-7005
Type: Location
Notre Dame Avenue, Chatsworth Neighborhood Council District, Los Angeles, Los Angeles County, California, 91304, United States
CHATSWORTH, CA 91311
Phone: (818) 610-1113
Fax: (818) 348-7005
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91303)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | CA | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 621 | 223 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | WI | |
| Mental Health Counselor | WI | |
| P S Y C H I A T R Y | NY | |
| Mental Health Counselor | WI | |
| - | WI | |
| Mental Health Counselor | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| P S Y C H I A T R Y | WI | |
| Clinical Psychologist | WI |
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