Healthcare Provider Details

I. General information

NPI: 1437856713
Provider Name (Legal Business Name): FOVEO HEALTHCARE A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E OLIVE AVE STE 440
BURBANK CA
91501-2171
US

IV. Provider business mailing address

500 E OLIVE AVE STE 440
BURBANK CA
91501-2171
US

V. Phone/Fax

Practice location:
  • Phone: 818-254-9967
  • Fax: 818-254-9967
Mailing address:
  • Phone: 818-254-9967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. KONSTANTINOS TRIPODIS
Title or Position: PROVIDER/OWNER
Credential: MD
Phone: 818-254-9967