Healthcare Provider Details

I. General information

NPI: 1437615135
Provider Name (Legal Business Name): ERIC SAENZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 S BRAND BLVD
SAN FERNANDO CA
91340-4002
US

IV. Provider business mailing address

7843 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91605-2523
US

V. Phone/Fax

Practice location:
  • Phone: 818-898-0223
  • Fax:
Mailing address:
  • Phone: 818-384-4566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW138722
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: