Provider Demographics
NPI:1083978449
Name:KAUFMAN, ANYA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANYA
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANYA
Other - Middle Name:
Other - Last Name:KAUFMAN-SHIMADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5650 TOPEKA DR
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1314
Mailing Address - Country:US
Mailing Address - Phone:818-304-6419
Mailing Address - Fax:818-708-7437
Practice Address - Street 1:6433 PONCE AVE
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3617
Practice Address - Country:US
Practice Address - Phone:818-304-6419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-30
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS219151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical