Healthcare Provider Details

I. General information

NPI: 1407660251
Provider Name (Legal Business Name): PARENTS ANONYMOUS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16600 SHERMAN WAY STE 280
VAN NUYS CA
91406-3785
US

IV. Provider business mailing address

16600 SHERMAN WAY STE 280
VAN NUYS CA
91406-3785
US

V. Phone/Fax

Practice location:
  • Phone: 818-221-1572
  • Fax:
Mailing address:
  • Phone: 818-221-1572
  • Fax: 909-621-0614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CARLOS VELASCO
Title or Position: HEAD OF SERVICE
Credential: LPCC
Phone: 323-354-9242