Healthcare Provider Details

I. General information

NPI: 1346719788
Provider Name (Legal Business Name): RUZANNA JURIAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9535 RESEDA BLVD STE 112
NORTHRIDGE CA
91324-6022
US

IV. Provider business mailing address

PO BOX 280593
NORTHRIDGE CA
91328-0593
US

V. Phone/Fax

Practice location:
  • Phone: 818-741-3141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RUZANNA JURIAN
Title or Position: LMFT/OWNER
Credential:
Phone: 818-741-3141