Healthcare Provider Details

I. General information

NPI: 1942104773
Provider Name (Legal Business Name): BUKHT AWER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17000 VENTURA BLVD STE 220
ENCINO CA
91316-4158
US

IV. Provider business mailing address

17045 ROSCOE BLVD UNIT 15
NORTHRIDGE CA
91325-5206
US

V. Phone/Fax

Practice location:
  • Phone: 818-357-0604
  • Fax:
Mailing address:
  • Phone: 818-357-0604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number103334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: