Provider Demographics
NPI:1255660932
Name:GREATHOUSE PARKER, VICTORIA (MS, MFT)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:GREATHOUSE PARKER
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:DENISE
Other - Last Name:GREATHOUSE-PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21243 VENTURA BLVD
Mailing Address - Street 2:SUITE 139
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2109
Mailing Address - Country:US
Mailing Address - Phone:818-676-1363
Mailing Address - Fax:
Practice Address - Street 1:21243 VENTURA BLVD
Practice Address - Street 2:SUITE 139
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2109
Practice Address - Country:US
Practice Address - Phone:818-676-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMFC 38916106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist