Healthcare Provider Details

I. General information

NPI: 1114850575
Provider Name (Legal Business Name): TARZANA TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18646 OXNARD ST
TARZANA CA
91356-1486
US

IV. Provider business mailing address

18646 OXNARD ST
TARZANA CA
91356-1486
US

V. Phone/Fax

Practice location:
  • Phone: 818-996-1051
  • Fax: 818-996-1051
Mailing address:
  • Phone: 818-996-1051
  • Fax: 818-996-1051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. GEOVANNI DAVID PLACERES
Title or Position: COUNSELOR 1
Credential:
Phone: 661-235-3602