Healthcare Provider Details

I. General information

NPI: 1407494404
Provider Name (Legal Business Name): ARIELLE KRUPNIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16255 VENTURA BLVD
ENCINO CA
91436-2302
US

IV. Provider business mailing address

5568 VALLEY CIRCLE BLVD
WOODLAND HILLS CA
91367-4060
US

V. Phone/Fax

Practice location:
  • Phone: 818-941-3388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: