Healthcare Provider Details

I. General information

NPI: 1821532771
Provider Name (Legal Business Name): ANASTASIA ZHURAVLEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 WILSHIRE BLVD STE 300
LOS ANGELES CA
90010-3512
US

IV. Provider business mailing address

4221 WILSHIRE BLVD STE 300
LOS ANGELES CA
90010-3512
US

V. Phone/Fax

Practice location:
  • Phone: 323-866-1880
  • Fax: 323-866-1881
Mailing address:
  • Phone: 323-866-1880
  • Fax: 323-866-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: