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General NPI Number Information
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NPI Number | 1346253929
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Entity Type | Individual
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Provider Name | MARY ELAINE CHERNOFF MFT
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5923 KANAN RD SUITE 204
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1688
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Country | US
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Telephone | 818-889-6764
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Fax | 818-991-4918
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Provider Business Mailing Address
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Address Line | 5308 CHRISTIAN CT
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4078
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Country | US
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Telephone | 818-889-6764
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Fax | 818-991-4918
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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 | LEP 2366
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M11657
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License Number State | CA
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