Provider Demographics
NPI:1417572041
Name:BODOZIAN, JANET A (AMFT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:A
Last Name:BODOZIAN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 ARCHWOOD ST.
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606
Mailing Address - Country:US
Mailing Address - Phone:818-468-7657
Mailing Address - Fax:
Practice Address - Street 1:15336 DEVONSHIRE ST # 6
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2755
Practice Address - Country:US
Practice Address - Phone:323-879-9176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health