Healthcare Provider Details

I. General information

NPI: 1366377046
Provider Name (Legal Business Name): LEE-EL RIVA ASULIN PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4029 LAS VIRGENES RD
CALABASAS CA
91302-1927
US

IV. Provider business mailing address

21650 BURBANK BLVD UNIT 323
WOODLAND HILLS CA
91367-7426
US

V. Phone/Fax

Practice location:
  • Phone: 818-880-4614
  • Fax:
Mailing address:
  • Phone: 818-854-9907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number260152823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: