Healthcare Provider Details

I. General information

NPI: 1033851969
Provider Name (Legal Business Name): HANNAH TALAVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date: 06/26/2023
Reactivation Date: 07/13/2023

III. Provider practice location address

15305 RAYEN ST
NORTH HILLS CA
91343-5117
US

IV. Provider business mailing address

15305 RAYEN ST
NORTH HILLS CA
91343-5117
US

V. Phone/Fax

Practice location:
  • Phone: 818-892-3423
  • Fax:
Mailing address:
  • Phone: 818-892-3423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW123907
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: