Healthcare Provider Details

I. General information

NPI: 1396418448
Provider Name (Legal Business Name): ELIZABETH CHRISTINE KOZARIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13130 BURBANK BLVD
SHERMAN OAKS CA
91401-6000
US

IV. Provider business mailing address

13130 BURBANK BLVD
SHERMAN OAKS CA
91401-6000
US

V. Phone/Fax

Practice location:
  • Phone: 818-781-0360
  • Fax:
Mailing address:
  • Phone: 818-781-0360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: