Healthcare Provider Details

I. General information

NPI: 1447015003
Provider Name (Legal Business Name): AMOR FAMILY THERAPY PROF CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23550 LYONS AVE STE 211
NEWHALL CA
91321-5745
US

IV. Provider business mailing address

23550 LYONS AVE STE 211
NEWHALL CA
91321-5745
US

V. Phone/Fax

Practice location:
  • Phone: 661-230-6267
  • Fax:
Mailing address:
  • Phone: 661-230-6267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JURIANA HERNANDEZ
Title or Position: PRESIDENT
Credential: LMFT
Phone: 661-505-0680