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General NPI Number Information
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NPI Number | 1447803986
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Entity Type | Individual
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Provider Name | VICTOR COVARRUBIAS PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 21550 OXNARD ST FL 3
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-7105
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Country | US
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Telephone | 818-913-0090
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Fax | 747-888-5865
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Provider Business Mailing Address
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Address Line | 21550 OXNARD ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-7100
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Country | US
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Telephone | 818-850-3250
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 95147346
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95024768
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License Number State | CA
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