Healthcare Provider Details

I. General information

NPI: 1588952386
Provider Name (Legal Business Name): JAMIE FARYL COHEN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30740 RUSSELL RANCH RD
WESTLAKE VILLAGE CA
91362-6399
US

IV. Provider business mailing address

17310 VENTURA BLVD
ENCINO CA
91316-3904
US

V. Phone/Fax

Practice location:
  • Phone: 818-889-8200
  • Fax: 818-532-2798
Mailing address:
  • Phone: 818-990-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14243
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: