Healthcare Provider Details

I. General information

NPI: 1235993130
Provider Name (Legal Business Name): NEUROSERENITY PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25350 MAGIC MOUNTAIN PKWY STE 300
VALENCIA CA
91355-1356
US

IV. Provider business mailing address

PO BOX 882021
SAN DIEGO CA
92168-2021
US

V. Phone/Fax

Practice location:
  • Phone: 424-225-0964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY ODOZI
Title or Position: PSYCHOLOGIST
Credential:
Phone: 424-225-0964