Provider Demographics
NPI:1437555307
Name:PADILLA, FELIX
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:PADILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8741 LAUREL CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2919
Mailing Address - Country:US
Mailing Address - Phone:818-768-5525
Mailing Address - Fax:818-768-5530
Practice Address - Street 1:8741 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2919
Practice Address - Country:US
Practice Address - Phone:818-768-5525
Practice Address - Fax:818-768-5530
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19-150101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7128OtherDRUG MEDICAL