Healthcare Provider Details

I. General information

NPI: 1285196600
Provider Name (Legal Business Name): HENRY SESSANGA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16500 VENTURA BLVD STE 414
ENCINO CA
91436-5050
US

IV. Provider business mailing address

16500 VENTURA BLVD STE 414
ENCINO CA
91436-5050
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-1003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: