Healthcare Provider Details

I. General information

NPI: 1114874955
Provider Name (Legal Business Name): IRMA GALVAN AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11712 MOORPARK ST STE 211
STUDIO CITY CA
91604-2164
US

IV. Provider business mailing address

24355 CREEKSIDE RD UNIT 801594
SANTA CLARITA CA
91380-7107
US

V. Phone/Fax

Practice location:
  • Phone: 818-210-8785
  • Fax:
Mailing address:
  • Phone: 818-210-8785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT154199
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: