=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902353618
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSANA CORIA ALANIZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2016
-----------------------------------------------------
Last Update Date | 12/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 135 E OLIVE AVE # 667
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91502-1820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-338-2707
-----------------------------------------------------
Fax | 818-304-9051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 135 E OLIVE AVE # 667
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91502-1820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-338-2707
-----------------------------------------------------
Fax | 818-304-9051
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 92772
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------