Healthcare Provider Details

I. General information

NPI: 1215885546
Provider Name (Legal Business Name): AMY ELIZABETH PAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12513 GAIN ST
PACOIMA CA
91331-1628
US

IV. Provider business mailing address

10660 WHITE OAK AVE STE B101
GRANADA HILLS CA
91344-5943
US

V. Phone/Fax

Practice location:
  • Phone: 818-480-6810
  • Fax:
Mailing address:
  • Phone: 818-230-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250152457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: