Healthcare Provider Details

I. General information

NPI: 1386431070
Provider Name (Legal Business Name): CHLORIZA AVILA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6736 LAUREL CANYON BLVD STE 200
NORTH HOLLYWOOD CA
91606-1576
US

IV. Provider business mailing address

PO BOX 5329
SHERMAN OAKS CA
91413-5329
US

V. Phone/Fax

Practice location:
  • Phone: 818-755-8786
  • Fax:
Mailing address:
  • Phone: 209-681-3096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT164051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: