Healthcare Provider Details

I. General information

NPI: 1457033474
Provider Name (Legal Business Name): MRS. NITA ANAVIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 TOWNSGATE RD STE 110
WESTLAKE VILLAGE CA
91361-5971
US

IV. Provider business mailing address

2535 TOWNSGATE RD STE 110
WESTLAKE VILLAGE CA
91361-5971
US

V. Phone/Fax

Practice location:
  • Phone: 805-702-3427
  • Fax:
Mailing address:
  • Phone: 805-702-3427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17894
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: