Healthcare Provider Details

I. General information

NPI: 1275554545
Provider Name (Legal Business Name): NITZA VARDI ZEMEL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19634 VENTURA BLVD SUITE 206
TARZANA CA
91356-2966
US

IV. Provider business mailing address

19634 VENTURA BLVD SUITE 206
TARZANA CA
91356-2966
US

V. Phone/Fax

Practice location:
  • Phone: 818-881-1753
  • Fax: 818-881-9263
Mailing address:
  • Phone: 818-881-1753
  • Fax: 818-881-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC25970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: