Healthcare Provider Details

I. General information

NPI: 1992173553
Provider Name (Legal Business Name): ERIK VALVERDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17200 VENTURA BLVD 125
ENCINO CA
91316-4005
US

IV. Provider business mailing address

17200 VENTURA BLVD 125
ENCINO CA
91316-4005
US

V. Phone/Fax

Practice location:
  • Phone: 818-268-4475
  • Fax:
Mailing address:
  • Phone: 818-268-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT 80923
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-17229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: