Healthcare Provider Details

I. General information

NPI: 1518363597
Provider Name (Legal Business Name): DV THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 S LA CIENEGA BLVD STE 208
LOS ANGELES CA
90035-2680
US

IV. Provider business mailing address

1080 S LA CIENEGA BLVD STE 208
LOS ANGELES CA
90035-2680
US

V. Phone/Fax

Practice location:
  • Phone: 323-426-6402
  • Fax: 323-714-0112
Mailing address:
  • Phone: 323-426-6402
  • Fax: 323-714-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-8177
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13868
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3632
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3202
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19686
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10093
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21403
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17647
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22705
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10094
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21109
License Number StateCA
# 12
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17904
License Number StateCA

VIII. Authorized Official

Name: IDDO DEVRIES
Title or Position: OWNER
Credential: M.S.CCC-SLP
Phone: 323-426-6402