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NPI Code Detail

MEDICARE: SOFIA NICOLE VIZULIS

MEDICARE: SOFIA NICOLE VIZULIS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1558928697
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOFIA NICOLE VIZULIS
Provider Business Mailing Address
First Line : 1301 E ORANGEWOOD AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6807
Country : US
Telephone Number : 800-249-1266
Fax Number :
Provider Business Practice Location Address
First Line : 2625 TOWNSGATE RD STE 102
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-5726
Country : US
Telephone Number : 805-413-3009
Fax Number : 805-413-4462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2019
Last Update Date : 09/01/2023

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Directions to “ SOFIA NICOLE VIZULIS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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