Healthcare Provider Details

I. General information

NPI: 1730642117
Provider Name (Legal Business Name): ENRICHMENT INTERVENTION FAMILY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21051 WARNER CENTER LN STE 100
WOODLAND HILLS CA
91367-6566
US

IV. Provider business mailing address

21051 WARNER CENTER LN STE 100
WOODLAND HILLS CA
91367-6566
US

V. Phone/Fax

Practice location:
  • Phone: 424-400-4119
  • Fax: 888-375-2151
Mailing address:
  • Phone: 424-400-4119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: INNA PINKHASOVA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 424-400-4119