Basic Information
| Provider Information | |||||||||
| NPI: | 1235809286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VELJANOVSKI | ||||||||
| FirstName: | SVITLANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12320 BURBANK BLVD APT 105 | ||||||||
| Address2: | |||||||||
| City: | VALLEY VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916071754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235041123 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1225 W 6TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927032101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149721402 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2021 | ||||||||
| LastUpdateDate: | 10/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | AMFT107473 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.