Healthcare Provider Details

I. General information

NPI: 1063391415
Provider Name (Legal Business Name): NEW VISION IOP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18425 BURBANK BLVD STE 609
TARZANA CA
91356-2806
US

IV. Provider business mailing address

18425 BURBANK BLVD STE 609
TARZANA CA
91356-2806
US

V. Phone/Fax

Practice location:
  • Phone: 818-600-8640
  • Fax: 818-600-8465
Mailing address:
  • Phone: 818-600-8640
  • Fax: 818-600-8465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. IRENE NAYGAS
Title or Position: CEO
Credential: PHARM D
Phone: 818-600-8640