Provider Demographics
NPI:1346432689
Name:PODINA, ANA PODINA JESSICA (BS)
Entity Type:Individual
Prefix:MS
First Name:ANA PODINA
Middle Name:JESSICA
Last Name:PODINA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 LENNOX AVE.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:90046-9214
Mailing Address - Country:US
Mailing Address - Phone:818-989-9217
Mailing Address - Fax:818-989-9217
Practice Address - Street 1:6851 LENNOX AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4073
Practice Address - Country:US
Practice Address - Phone:818-989-9217
Practice Address - Fax:818-989-9217
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator