Healthcare Provider Details

I. General information

NPI: 1629191689
Provider Name (Legal Business Name): JAMI T. OPYAN MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15235 BURBANK BLVD SUITE B6
SHERMAN OAKS CA
91411-3500
US

IV. Provider business mailing address

19127 INDEX ST UNIT 2
PORTER RANCH CA
91326-1647
US

V. Phone/Fax

Practice location:
  • Phone: 818-516-5354
  • Fax:
Mailing address:
  • Phone: 818-516-5354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC47692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: