Basic Information
| Provider Information | |||||||||
| NPI: | 1417572041 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BODOZIAN | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | AMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13121 ARCHWOOD ST. | ||||||||
| Address2: | |||||||||
| City: | NORTH HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8184687657 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15336 DEVONSHIRE ST # 6 | ||||||||
| Address2: | |||||||||
| City: | MISSION HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913452755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238799176 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2020 | ||||||||
| LastUpdateDate: | 06/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 112619 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.