Provider Demographics
NPI:1366473506
Name:VOSEN, LEONARD M (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:M
Last Name:VOSEN
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:17130 DEVONSHIRE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1673
Mailing Address - Country:US
Mailing Address - Phone:818-885-5966
Mailing Address - Fax:818-885-5966
Practice Address - Street 1:17075 DEVONSHIRE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1600
Practice Address - Country:US
Practice Address - Phone:818-885-5966
Practice Address - Fax:818-885-5966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2013-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY3021103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP3021AMedicare PIN