Healthcare Provider Details

I. General information

NPI: 1346009354
Provider Name (Legal Business Name): VASILIKY KYRIAKOPOULOS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9957 FRANCE AVE
TUJUNGA CA
91042-2841
US

IV. Provider business mailing address

7555 VAN NUYS BLVD
VAN NUYS CA
91405-1949
US

V. Phone/Fax

Practice location:
  • Phone: 818-489-3756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW25772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: