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General NPI Number Information
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NPI Number | 1427498468
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Entity Type | Individual
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Provider Name | JANE ISRAYELYAN LICENSED MARRIAGE AN
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Gender | Female
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 516 PENNSFIELD PL. #100
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City | THOUSAND OAKS
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State | CA
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Zip | 91360
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Country | US
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Telephone | 805-608-3625
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Fax |
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Provider Business Mailing Address
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Address Line | 100-190 RANCHO RD #282 516 PENNSFIELD PL. #100
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City | THOUSAND OAKS
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State | CA
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Zip | 91360
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Country | US
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Telephone | 323-809-3854
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | RS6535
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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 |
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License Number State |
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