Healthcare Provider Details

I. General information

NPI: 1285702951
Provider Name (Legal Business Name): BIANA BOCHKUR PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11336 DONA LISA DR
STUDIO CITY CA
91604-4315
US

IV. Provider business mailing address

13701 RIVERSIDE DR STE 700
SHERMAN OAKS CA
91423-2449
US

V. Phone/Fax

Practice location:
  • Phone: 323-356-9993
  • Fax:
Mailing address:
  • Phone: 818-788-7580
  • Fax: 818-788-7540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY19067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: