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General NPI Number Information
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NPI Number | 1063600732
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Entity Type | Individual
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Provider Name | DR. ANTHONY ODOZI
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Gender | Male
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 25350 MAGIC MOUNTAIN PKWY STE 300
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City | VALENCIA
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State | CA
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Zip | 91355-1356
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Country | US
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Telephone | 424-225-0964
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 882021
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City | SAN DIEGO
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State | CA
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Zip | 92168-2021
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Country | US
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Telephone | 424-225-0964
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY33276
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY33276
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License Number State | CA
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