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NPI Code Detail

MEDICARE: MS. YEVGENIYA SELEZNYEV

MEDICARE: MS. YEVGENIYA SELEZNYEV
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1386862357
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. YEVGENIYA SELEZNYEV
Provider Business Mailing Address
First Line : 1318 N ORANGE DR APT 303
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-7571
Country : US
Telephone Number : 323-962-4493
Fax Number :
Provider Business Practice Location Address
First Line : 14558 SYLVAN ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-2324
Country : US
Telephone Number : 818-787-4151
Fax Number : 818-787-2840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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Directions to “ MS. YEVGENIYA SELEZNYEV ” Practice Location

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