Healthcare Provider Details

I. General information

NPI: 1881105195
Provider Name (Legal Business Name): ANESCIA YVETTE BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2017
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16600 SHERMAN WAY STE 178
VAN NUYS CA
91406-3875
US

IV. Provider business mailing address

16600 SHERMAN WAY STE 178
VAN NUYS CA
91406-3875
US

V. Phone/Fax

Practice location:
  • Phone: 951-922-5792
  • Fax:
Mailing address:
  • Phone: 951-922-5792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110942
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT152582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: