MEDICARE: CIBV FOUNDATION

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1871440651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIBV FOUNDATION

Provider Business Mailing Address
First Line	:	2312 S DUNSMUIR AVE UNIT A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-2100
Country	:	US
Telephone Number	:	702-810-0214
Fax Number	:

Provider Business Practice Location Address
First Line	:	20300 VENTURA BLVD STE 340
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-0915
Country	:	US
Telephone Number	:	323-403-5585
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. BRIAN WILLIAMS
Credential	:
Telephone Number	:	702-810-0214

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “CIBV FOUNDATION ” Practice Location

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