Healthcare Provider Details

I. General information

NPI: 1841841368
Provider Name (Legal Business Name): JENNIFER BRIZUELA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11684 VENTURA BLVD # 1050
STUDIO CITY CA
91604-2699
US

IV. Provider business mailing address

11684 VENTURA BLVD # 1050
STUDIO CITY CA
91604-2699
US

V. Phone/Fax

Practice location:
  • Phone: 818-308-5746
  • Fax:
Mailing address:
  • Phone: 818-308-5746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW85881
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: