Healthcare Provider Details

I. General information

NPI: 1699025031
Provider Name (Legal Business Name): JENNIFER LYNN PODELL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16055 VENTURA BLVD STE 500
ENCINO CA
91436-2605
US

IV. Provider business mailing address

16055 VENTURA BLVD STE 500
ENCINO CA
91436-2605
US

V. Phone/Fax

Practice location:
  • Phone: 818-521-7374
  • Fax:
Mailing address:
  • Phone: 818-971-9723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY25095
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: