Healthcare Provider Details

I. General information

NPI: 1497545529
Provider Name (Legal Business Name): FAMILY INSIGHT & INDIVIDUAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13126 1/4 VALLEYHEART DR
STUDIO CITY CA
91604-1980
US

IV. Provider business mailing address

12605 VENTURA BLVD # 1078
STUDIO CITY CA
91604-2415
US

V. Phone/Fax

Practice location:
  • Phone: 310-430-5088
  • Fax:
Mailing address:
  • Phone: 310-430-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LUKAS DZIEMIDOK
Title or Position: PRESIDENT
Credential:
Phone: 747-356-8388