Basic Information
Provider Information
NPI: 1275554545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZEMEL
FirstName: NITZA
MiddleName: VARDI
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19634 VENTURA BLVD
Address2: SUITE 206
City: TARZANA
State: CA
PostalCode: 913562966
CountryCode: US
TelephoneNumber: 8188811753
FaxNumber: 8188819263
Practice Location
Address1: 19634 VENTURA BLVD
Address2: SUITE 206
City: TARZANA
State: CA
PostalCode: 913562966
CountryCode: US
TelephoneNumber: 8188811753
FaxNumber: 8188819263
Other Information
ProviderEnumerationDate: 07/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XMFC25970CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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