Healthcare Provider Details

I. General information

NPI: 1134760622
Provider Name (Legal Business Name): SUNAYANA KAVIYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2019
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1534 N MOORPARK RD STE 1171000
THOUSAND OAKS CA
91360-5129
US

IV. Provider business mailing address

1800 W HILLCREST DR APT 358
THOUSAND OAKS CA
91320-2341
US

V. Phone/Fax

Practice location:
  • Phone: 240-418-6991
  • Fax:
Mailing address:
  • Phone: 240-418-6991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number132925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: