Healthcare Provider Details

I. General information

NPI: 1568275345
Provider Name (Legal Business Name): IZACARE BEHAVIOR SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13084 BEAVER ST
SYLMAR CA
91342-2511
US

IV. Provider business mailing address

13084 BEAVER ST
SYLMAR CA
91342-2511
US

V. Phone/Fax

Practice location:
  • Phone: 747-209-0009
  • Fax: 747-209-0006
Mailing address:
  • Phone: 747-209-0009
  • Fax: 747-209-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: IZABELLA PETROSYAN
Title or Position: CEO
Credential:
Phone: 818-433-2159