Provider Demographics
NPI:1528191525
Name:SIMON, VICTORIA MARIE (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:MARIE
Last Name:SIMON
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 LAUREL CANYON BLVD # 213
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3709
Mailing Address - Country:US
Mailing Address - Phone:323-806-0561
Mailing Address - Fax:
Practice Address - Street 1:601 S GLENOAKS BLVD
Practice Address - Street 2:#200
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1474
Practice Address - Country:US
Practice Address - Phone:818-441-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37594101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor