Healthcare Provider Details

I. General information

NPI: 1558282038
Provider Name (Legal Business Name): RADIANT RECLAMATION FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16530 VENTURA BLVD STE 400
ENCINO CA
91436-4551
US

IV. Provider business mailing address

PO BOX 55511
VALENCIA CA
91385-0511
US

V. Phone/Fax

Practice location:
  • Phone: 661-878-1061
  • Fax: 661-481-7360
Mailing address:
  • Phone: 661-878-1061
  • Fax: 661-481-7360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYBRINA CORTNEY LOPEZ
Title or Position: LMFT
Credential: LMFT
Phone: 661-878-1061